Individual
SHANHAT YACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
4820 LINCOLN BLVD, MARINA DEL REY, CA 90292-6917
(310) 392-7889
Mailing address
4820 LINCOLN BLVD, MARINA DEL REY, CA 90292-6917
(310) 392-7889
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
307932
CA
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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