Organization
WEST COAST PEDIATRIC GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMED SHABAN MD (PHYSICIAN)
(562) 459-5271
Entity
Organization
Contact information
Practice address
1330 W COVINA BLVD STE 201, SAN DIMAS, CA 91773-3200
(760) 401-9525
Mailing address
1330 W COVINA BLVD STE 201, SAN DIMAS, CA 91773-3200
(760) 401-9525
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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