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General NPI Number Information
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NPI Number | 1306975982
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Entity Type | Individual
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Provider Name | B G SHILY O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 9100 WILSHIRE BLVD STE 509E
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3419
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Country | US
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Telephone | 310-271-3937
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Fax | 310-271-3959
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Provider Business Mailing Address
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Address Line | 9100 WILSHIRE BLVD 509E
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3415
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Country | US
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Telephone | 310-271-3937
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Fax | 310-271-3959
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8177T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 8177T
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License Number State | CA
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