Provider Demographics
NPI:1902156904
Name:NAIK, SHILPA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 MURPHY CANYON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4411
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:
Practice Address - Street 1:250 E CHASE AVE STE 108
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6305
Practice Address - Country:US
Practice Address - Phone:619-442-2560
Practice Address - Fax:619-442-7836
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122868208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA122868OtherMEDICAL BOARD OF CALIFORNIA
CA1902156904Medicaid