Individual
ELLEN SHUHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
18661 DEVONSHIRE ST, NORTHRIDGE, CA 91324
(818) 368-1234
(818) 363-3161
Mailing address
18661 DEVONSHIRE ST, NORTHRIDGE, CA 91324
(818) 368-1234
(818) 363-3161
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT6899TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0068990
—
CA
Enumeration date
01/09/2007
Last updated
11/17/2009
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