Healthcare Provider Details

I. General information

NPI: 1184185043
Provider Name (Legal Business Name): SHANPENG LI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLAZA (ANESTHESIOLOGY)
LOS ANGELES CA
90095-7419
US

IV. Provider business mailing address

757 WESTWOOD PLAZA (ANESTHESIOLOGY)
LOS ANGELES CA
90095-7419
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-8655
  • Fax: 310-267-3766
Mailing address:
  • Phone: 310-267-8655
  • Fax: 310-267-3766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberA182410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: