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Organization

ALAN L. SHABO M.D. A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN LOUIS SHABO M.D. (PHYSICIAN&SURGEON/OPHTHALMOLOGIST)
(310) 824-9661
Entity
Organization

Contact information

Practice address
10921 WILSHIRE BLVD, SUITE 1205, LOS ANGELES, CA 90024-3906
(310) 824-9661
(310) 824-9867
Mailing address
10921 WILSHIRE BLVD, SUITE 1205, LOS ANGELES, CA 90024-3906
(310) 824-9661
(310) 824-9867

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A23893
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01112710004286-001
CCN
01
A23893
PTAN
CA
Enumeration date
03/19/2012
Last updated
03/19/2012
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