Provider Demographics
NPI:1013929157
Name:ELSHIMALI, YAHYA IBRAHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:YAHYA
Middle Name:IBRAHIM
Last Name:ELSHIMALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JHON YAHYA
Other - Middle Name:IBRAHIM
Other - Last Name:ELSHIMALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7855 HASKELL AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-1902
Mailing Address - Country:US
Mailing Address - Phone:818-994-9714
Mailing Address - Fax:818-994-9875
Practice Address - Street 1:7855 HASKELL AVE
Practice Address - Street 2:SUITE # 302
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-1900
Practice Address - Country:US
Practice Address - Phone:818-515-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55296281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA55296Medicare ID - Type Unspecified