Healthcare Provider Details

I. General information

NPI: 1174779433
Provider Name (Legal Business Name): SHAYNAN WYNNE HILL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N ROBERTSON BLVD SUITE 601
BEVERLY HILLS CA
90211-1788
US

IV. Provider business mailing address

250 N ROBERTSON BLVD SUITE 601
BEVERLY HILLS CA
90211-1788
US

V. Phone/Fax

Practice location:
  • Phone: 310-385-3534
  • Fax: 310-385-3577
Mailing address:
  • Phone: 310-385-3534
  • Fax: 310-385-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS016656
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: