Provider Demographics
NPI:1841529757
Name:HILLYER, SHAHAB P (MD)
Entity type:Individual
Prefix:
First Name:SHAHAB
Middle Name:P
Last Name:HILLYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 STOCKDALE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3611
Mailing Address - Country:US
Mailing Address - Phone:661-664-2200
Mailing Address - Fax:
Practice Address - Street 1:9300 STOCKDALE HWY STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3611
Practice Address - Country:US
Practice Address - Phone:661-664-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120045208800000X
OH35.094810208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology