Provider Demographics
NPI:1134215395
Name:SHAYFER, SOHAIL (MD)
Entity type:Individual
Prefix:DR
First Name:SOHAIL
Middle Name:
Last Name:SHAYFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:S
Other - Last Name:SHAYFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:16055 VENTURA BLVD STE 444
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2608
Mailing Address - Country:US
Mailing Address - Phone:818-981-3688
Mailing Address - Fax:818-981-3588
Practice Address - Street 1:16055 VENTURA BLVD STE 444
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2608
Practice Address - Country:US
Practice Address - Phone:818-981-3688
Practice Address - Fax:818-981-3588
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84464207XS0106X, 2251X0800X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G84464Medicaid
CA00G84464Medicaid