Healthcare Provider Details

I. General information

NPI: 1578719274
Provider Name (Legal Business Name): SHILPA SWAMY MBBS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 S FAIR OAKS AVE
PASADENA CA
91105-2626
US

IV. Provider business mailing address

988 S FAIR OAKS AVE
PASADENA CA
91105-2626
US

V. Phone/Fax

Practice location:
  • Phone: 626-799-4194
  • Fax:
Mailing address:
  • Phone: 626-799-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA126538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: