Provider Demographics
NPI:1538265160
Name:SHOJI, ELAINE CAROLE (MD)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:CAROLE
Last Name:SHOJI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:827 DEEP VALLEY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3647
Mailing Address - Country:US
Mailing Address - Phone:310-541-8801
Mailing Address - Fax:310-541-8703
Practice Address - Street 1:827 DEEP VALLEY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3647
Practice Address - Country:US
Practice Address - Phone:310-541-8801
Practice Address - Fax:310-541-8703
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2012-01-24
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Provider Licenses
StateLicense IDTaxonomies
CAG35402208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG35402OtherSTATE LICENSE
CA33-0277966OtherFEDERAL TAX I.D.