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Provider Information for 1871655654

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MR. IRAJ SHAMSA M.D.

Gender: MALE

Individual NPI: 1871655654

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1871655654
Enumeration Date 2006-12-15
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 14624 SHERMAN WAY SUITE 206
VAN NUYS, CA 91405-2241
United States

Phone: 818-994-7353 | Fax: 818-994-1092
View Map External Link
Primary Practice Address 14624 SHERMAN WAY SUITE 206
VAN NUYS, CA 91405-2241
United States

Phone: 818-994-7353 | Fax: 818-994-1092
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine CA A49893