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Individual

ELSAGAV S SHAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
866 N VERMONT AVE, #1, LOS ANGELES, CA 90029-3528
(323) 660-2100
(323) 662-0078
Mailing address
866 N VERMONT AVE, #1, LOS ANGELES, CA 90029-3528
(323) 660-2100
(323) 662-0078

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G50824
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G508240
CA
Enumeration date
08/23/2005
Last updated
10/03/2013
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