Organization
BEN B. SHENASSA, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEHNAM BEN SHENASSA M.D. (INCORPORATOR)
(323) 543-4250
Entity
Organization
Contact information
Practice address
2750 W BROADWAY, LOS ANGELES, CA 90041-1050
(323) 543-4250
(323) 543-4255
Mailing address
2750 W BROADWAY, EAGLE ROCK, CA 90041-1050
(323) 543-4250
(323) 543-4255
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A76062
CA
Other
Enumeration date
01/16/2007
Last updated
07/06/2020
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