Individual
TAHER A SHAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
34845 YUCAIPA BLVD.,, SUITE #A, YUCAIPA, CA 92399-4237
(909) 480-5691
(909) 790-5878
Mailing address
34845 YUCAIPA BLVD.,, SUITE # A, YUCAIPA, CA 92399-4237
(909) 480-5691
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A41410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A414100
—
CA
Enumeration date
11/30/2006
Last updated
06/11/2010
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