Provider Demographics
NPI:1811330244
Name:SUBHASH, SNEHA (MD)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:SUBHASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SNEHA
Other - Middle Name:
Other - Last Name:SHAHANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14445 OLIVE VIEW DR. 6D116
Mailing Address - Street 2:OLIVE VIEW - UCLA MEDICAL CENTER
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:747-210-3222
Mailing Address - Fax:747-210-3255
Practice Address - Street 1:14445 OLIVE VIEW DR. 6D116
Practice Address - Street 2:OLIVE VIEW - UCLA MEDICAL CENTER
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:747-210-3222
Practice Address - Fax:747-210-3255
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA150201207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program