Individual
MARAT NADIROVICH SHAMSUTDINOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18040 SHERMAN WAY, RESEDA, CA 91335-4631
(818) 758-1236
Mailing address
18040 SHERMAN WAY, RESEDA, CA 91335-4631
(818) 758-1236
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
278379-1
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A136394
CA
2084P0804X
Child & Adolescent Psychiatry Physician
MD453570
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2014
Last updated
11/22/2021
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