Organization
AVA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMA SHOGHIAN-SHABANPOUR M.D. (DIRECTOR)
(714) 444-0044
Entity
Organization
Contact information
Practice address
1329 W WARNER AVE, SANTA ANA, CA 92704-5118
(714) 444-0044
(714) 444-0043
Mailing address
1329 W WARNER AVE, SANTA ANA, CA 92704-5118
(714) 444-0044
(714) 444-0043
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A80009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A80009
—
CA
Enumeration date
04/01/2008
Last updated
04/01/2008
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