Individual
SHOKOUH TAMADON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15111 WHITTIER BLVD, SUITE 102, WHITTIER, CA 90603-2136
(562) 945-6440
(562) 945-9121
Mailing address
15111 WHITTIER BLVD, SUITE 102, WHITTIER, CA 90603-2136
(562) 945-6440
(562) 945-9121
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A48517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A485170
BLUE SHIELD
CA
05
—
00A485170
—
CA
01
—
080181067
MEDICARE RAIL ROAD
CA
01
—
A48517
BCBS
CA
01
—
B002
CHAMPUS
CA
Enumeration date
07/13/2005
Last updated
04/20/2010
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