MEDICARE: DR. SHALINI KAPOOR M.D.

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	207W00000X	Ophthalmology Physician	C52055	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C52055	OTHER	CA	STATE MEDICAL LICENSE#

General Provider Information

NPI Number	:	1932206224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHALINI KAPOOR M.D.

Provider Business Mailing Address
First Line	:	4353 PARK TERRACE DR STE 150
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4631
Country	:	US
Telephone Number	:	805-987-5300
Fax Number	:	818-707-7668

Provider Business Practice Location Address
First Line	:	4353 PARK TERRACE DR STE 150
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4631
Country	:	US
Telephone Number	:	805-987-5300
Fax Number	:	818-707-7668

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/02/2013

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