Individual
ILEANA COMPANEITZ SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
191 S BUENA VISTA ST, SUITE 100, BURBANK, CA 91505-4554
(855) 723-3005
(855) 817-9681
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5691
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G53452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G534520
—
CA
Enumeration date
07/18/2006
Last updated
03/26/2014
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