Healthcare Provider Details

I. General information

NPI: 1316191455
Provider Name (Legal Business Name): SOHAIL SHAYFER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16055 VENTURA BLVD STE 444
ENCINO CA
91436-2601
US

IV. Provider business mailing address

16055 VENTURA BLVD STE 444
ENCINO CA
91436-2601
US

V. Phone/Fax

Practice location:
  • Phone: 818-981-3688
  • Fax: 818-981-3588
Mailing address:
  • Phone: 818-981-3688
  • Fax: 818-981-3588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberG84464
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG84464
License Number StateCA

VIII. Authorized Official

Name: SOHAIL SHAWN SHAYFER
Title or Position: OWNER
Credential: MD
Phone: 818-981-3688