Healthcare Provider Details
I. General information
NPI: 1235523473
Provider Name (Legal Business Name): MICHELLE ALLEN-SHARPLEY M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2015
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8700 BEVERLY BLVD STE 4221
WEST HOLLYWOOD CA
90048-1804
US
IV. Provider business mailing address
4140 W 190TH ST
TORRANCE CA
90504-5513
US
V. Phone/Fax
- Phone: 310-423-4441
- Fax: 310-423-1244
- Phone: 310-267-9129
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A147842 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | A147842 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: