Healthcare Provider Details

I. General information

NPI: 1205096633
Provider Name (Legal Business Name): ARVIND MANOHAR SHINDE M.D., M.B.A., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD CSMC - SAMUEL OSCHIN CANCER CENTER, ROOM AC1045
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

8700 BEVERLY BLVD CSMC - SAMUEL OSCHIN CANCER CENTER, ROOM AC1045
WEST HOLLYWOOD CA
90048-1804
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-6998
  • Fax: 310-423-4759
Mailing address:
  • Phone: 310-248-6998
  • Fax: 310-423-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA109250
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA 109250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: