MEDICARE: DR. ARVIND SHANKAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	G51070	CA

General Provider Information

NPI Number	:	1689835753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARVIND SHANKAR M.D.

Provider Business Mailing Address
First Line	:	12021 WILSHIRE BLVD
Second Line	:	NO. 413
City	:	W LOS ANGELES
State	:	CA
Zip	:	90025-1206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12021 WILSHIRE BLVD
Second Line	:	NO. 413
City	:	W LOS ANGELES
State	:	CA
Zip	:	90025-1206
Country	:	US
Telephone Number	:	310-893-6374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2008
Last Update Date	:	06/22/2008

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