Provider Demographics
NPI:1518716919
Name:UZIEL SHEFA MEDICAL SC
Entity type:Organization
Organization Name:UZIEL SHEFA MEDICAL SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAZA
Authorized Official - Middle Name:U
Authorized Official - Last Name:ATANELOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-933-5688
Mailing Address - Street 1:8200 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2328
Mailing Address - Country:US
Mailing Address - Phone:310-933-5688
Mailing Address - Fax:310-616-5188
Practice Address - Street 1:5454 FARGO AVE STE 107
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3210
Practice Address - Country:US
Practice Address - Phone:310-933-5688
Practice Address - Fax:310-616-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty