Individual
PUJA SHAHROUKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MOODY CT STE 200, THOUSAND OAKS, CA 91360-6082
(310) 301-6800
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
276542
MA
2085R0202X
Diagnostic Radiology Physician
Primary
A173721
CA
Other
Enumeration date
05/23/2018
Last updated
07/11/2023
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