Individual
MELIKA SHABANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15290 SW ROYALTY PKWY, TIGARD, OR 97224-4059
(818) 345-2345
Mailing address
21600 W OXNARD ST, #1800, WOODLAND HILLS, CA 91367
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BB501D0S
—
OR
Enumeration date
05/18/2021
Last updated
05/18/2021
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