Individual
DR. SHAHLA MODARRESI MOTAMEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11301 WILSHIRE BLVD, WEST LA V.A. HOSPITAL.,IMAGING DEPT.,BLDG 500,ROOM 0608, LOS ANGELES, CA 90073-1003
(310) 268-3591
(310) 575-6665
Mailing address
326 GEORGINA AVE, SANTA MONICA, CA 90402-1618
(310) 458-0050
(310) 575-6665
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A41382
CA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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