Organization
MODMD A PROFESSIONAL CORPORATION
Active
Organization
MODMD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON NAOMI DABBY MD (CEO/MD)
(833) 663-6352
Entity
Organization
Contact information
Practice address
208 LINCOLN BLVD, VENICE, CA 90291
(833) 663-6352
(424) 465-3398
Mailing address
208 LINCOLN BLVD, VENICE, CA 90291
(833) 663-6352
(424) 465-3398
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
02/04/2023
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