Individual
SHALA MOTAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
20969 VENTURA BLVD, 23, WOODLAND HILLS, CA 91364-2305
(818) 992-5252
(818) 992-5292
Mailing address
20969 VENTURA BLVD, 23, WOODLAND HILLS, CA 91364-2305
(818) 992-5252
(818) 992-5292
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT14153
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT14153
MEDICAL LICENSE
CA
Enumeration date
03/30/2010
Last updated
03/30/2010
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