Individual
DR. LAILA MOUSAVI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2435 COMMERCE AVE BLDG 2200, DULUTH, GA 30096-4980
(858) 472-6162
Mailing address
22542 SWANSTONE CT, FRANKFORT, IL 60423-9022
(858) 472-6162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14151
CA
Other
Enumeration date
06/23/2011
Last updated
04/03/2023
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