Provider Demographics
NPI:1326043456
Name:HINSHAW, CLAYTON T (MD)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:T
Last Name:HINSHAW
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 1:2925 SYCAMORE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1208
Mailing Address - Country:US
Mailing Address - Phone:805-409-9199
Mailing Address - Fax:805-416-0116
Practice Address - Street 1:2925 SYCAMORE DR STE 204
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1208
Practice Address - Country:US
Practice Address - Phone:805-409-9199
Practice Address - Fax:805-416-0116
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055224207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH24419Medicare UPIN