Individual
BOB BABAK SHAFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MEDICAL PLZ, SUITE 200, LOS ANGELES, CA 90095-0001
(310) 825-2111
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 825-5111
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A83576
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A835760
—
CA
Enumeration date
04/05/2007
Last updated
02/04/2015
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