Provider Demographics
NPI:1306933890
Name:TURRILL, SHADER & MYLES, M.D.'S, A PROFESSIONAL CORP
Entity type:Organization
Organization Name:TURRILL, SHADER & MYLES, M.D.'S, A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-241-1141
Mailing Address - Street 1:435 ARDEN AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1130
Mailing Address - Country:US
Mailing Address - Phone:818-241-1141
Mailing Address - Fax:818-459-0437
Practice Address - Street 1:435 ARDEN AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1130
Practice Address - Country:US
Practice Address - Phone:818-241-1141
Practice Address - Fax:818-459-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44750Medicare UPIN
CAW3069Medicare ID - Type Unspecified