Provider Demographics
NPI:1932206224
Name:KAPOOR, SHALINI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHALINI
Other - Middle Name:K
Other - Last Name:GROVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4353 PARK TERRACE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4631
Mailing Address - Country:US
Mailing Address - Phone:805-987-5300
Mailing Address - Fax:818-707-7668
Practice Address - Street 1:4353 PARK TERRACE DR STE 150
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4631
Practice Address - Country:US
Practice Address - Phone:805-987-5300
Practice Address - Fax:818-707-7668
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52055207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC52055OtherSTATE MEDICAL LICENSE#