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General NPI Number Information
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NPI Number | 1043761166
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Entity Type | Organization
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Legal Business Name | IGOR GARY SHLIFER DO P.C.
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 20301 VENTURA BLVD SUITE 210
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2447
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Country | US
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Telephone | 818-981-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 20301 VENTURA BLVD SUITE 210
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2447
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Country | US
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Telephone | 818-981-0080
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IGOR GARY SHLIFER
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Credential | D.O.
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Telephone | 818-346-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 20A14715
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License Number State | CA
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