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Organization
SHIVA SHABNAM MD
Active
Organization
SHIVA SHABNAM MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIVA SHABNAM MD (PRESIDENT)
(818) 674-0450
Entity
Organization
Contact information
Practice address
3275 TWEEDY BLVD, SOUTH GATE, CA 90280-4348
(818) 674-0450
(714) 731-8310
Mailing address
PO BOX 27851, ANAHEIM, CA 92809-0128
(818) 674-0450
(714) 731-8310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A110335
CA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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