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1710279625

NPI Code Detail

MEDICARE: SHIVANI SHODHAN MD, MPH

MEDICARE: SHIVANI SHODHAN MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	MD2023-0545	NM
2	207RI0011X	Interventional Cardiology Physician	58731	AZ
3	207RI0011X	Interventional Cardiology Physician	DR.0075449	CO
4	207RI0011X	Interventional Cardiology Physician	A136192	CA

General Provider Information

NPI Number	:	1710279625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVANI SHODHAN MD, MPH

Provider Business Mailing Address
First Line	:	PO BOX 512185
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 FIVEPOINT
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-2621
Country	:	US
Telephone Number	:	949-671-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2011
Last Update Date	:	04/09/2026

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Directions to “ SHIVANI SHODHAN MD, MPH” Practice Location

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