Individual
SHAMIM MOHAMED REMTULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8900 VENICE BLVD STE 109, CULVER CITY, CA 90232-2361
(424) 282-5696
Mailing address
3736 MCLAUGHLIN AVE, LOS ANGELES, CA 90066-3304
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21180
CA
Other
Enumeration date
12/13/2010
Last updated
07/27/2022
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