Individual
DR. SHITAL PAVAWALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 MEDICAL PLAZA # B200, LOS ANGELES, CA 90095-6361
(310) 794-1195
Mailing address
PO BOX 512717, LOS ANGELES, CA 90051-0717
(310) 967-1780
(323) 940-0182
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
24673
CA
Other
Enumeration date
06/06/2012
Last updated
09/16/2020
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