Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | G1973 | CA |
NPI | 1114299757 |
---|---|
Provider Name | Dr. Henry R Shinefield |
First Address | Beverly Hills, CA 90210-1611 |
Second Address | Beverly Hills, CA 90210-1611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2012 |
Last Update Date | 28/01/2012 |