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General NPI Number Information
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NPI Number | 1023454899
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Entity Type | Individual
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Provider Name | DR. SHIVANGI AMIN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 701 N ALVARADO ST
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City | LOS ANGELES
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State | CA
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Zip | 90026-4005
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Country | US
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Telephone | 213-908-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 188 THOMAS JOHNSON DR SUITE 102
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City | FREDERICK
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State | MD
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Zip | 21702-4505
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Country | US
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Telephone | 301-732-4154
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Fax | 240-651-1459
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0080834
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License Number State | MD
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