Healthcare Provider Details

I. General information

NPI: 1487769451
Provider Name (Legal Business Name): NAJWA M SHAMMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 W BURBANK BLVD
BURBANK CA
91506-1319
US

IV. Provider business mailing address

2006 W BURBANK BLVD
BURBANK CA
91506-1319
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-0390
  • Fax: 818-843-0714
Mailing address:
  • Phone: 818-843-0390
  • Fax: 818-843-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC37229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: