Individual
AVA T SHAMBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2021 SANTA MONICA BLVD, SUITE 600E, SANTA MONICA, CA 90404
(310) 828-2282
(310) 828-8504
Mailing address
2021 SANTA MONICA BLVD STE 600E, SANTA MONICA, CA 90404-2166
(310) 828-2282
(310) 828-8504
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G50969
CA
207NS0135X
Procedural Dermatology Physician
G50969
CA
Other
Enumeration date
08/22/2006
Last updated
05/03/2022
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