Provider Demographics
NPI:1386422236
Name:SHEFAH HEALTHCARE SC
Entity type:Organization
Organization Name:SHEFAH HEALTHCARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-933-5688
Mailing Address - Street 1:9171 WILSHIRE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5536
Mailing Address - Country:US
Mailing Address - Phone:310-933-5688
Mailing Address - Fax:
Practice Address - Street 1:5454 FARGO AVE STE 107
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3210
Practice Address - Country:US
Practice Address - Phone:310-933-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty