Basic Information
| Provider Information | |||||||||
| NPI: | 1215162193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHYE | ||||||||
| FirstName: | RITU | ||||||||
| MiddleName: | K | ||||||||
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| OtherLastName: | VAHI | ||||||||
| OtherFirstName: | RITU | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5767 W CENTURY BLVD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900455631 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 23861 MCBEAN PARKWAY | ||||||||
| Address2: | SUITE E24 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913555173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617535464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2009 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | A114512 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.