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Individual
MR. SHAHROKH SHABAHANG
Active
Individual
MR. SHAHROKH SHABAHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MS,PHD
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
35778
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35778
STATE LIC. #
CA
Enumeration date
03/06/2007
Last updated
07/08/2007
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