Provider Demographics
NPI:1902458524
Name:SHILPA DIWAN MD INC
Entity Type:Organization
Organization Name:SHILPA DIWAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHILPA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-304-6727
Mailing Address - Street 1:6 VENTURE STE 350
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7350
Mailing Address - Country:US
Mailing Address - Phone:949-304-6727
Mailing Address - Fax:760-859-3877
Practice Address - Street 1:19772 MACARTHUR BLVD STE 220
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2405
Practice Address - Country:US
Practice Address - Phone:949-304-6727
Practice Address - Fax:949-312-5638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-13
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty