Individual
MR. ROLAND DESHAWN SHAW
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
414 W 99TH ST, LOS ANGELES, CA 90003-3919
(323) 777-5016
(323) 777-2016
Mailing address
414 1/2 W 99TH ST, LOS ANGELES, CA 90003-3919
(323) 777-5016
(323) 777-2016
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/19/2005
Last updated
07/08/2007
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