Healthcare Provider Details
I. General information
NPI: 1902568280
Provider Name (Legal Business Name): SHEBA OPTIMUM CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2021
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2815 E CHEVY CHASE DR
GLENDALE CA
91206-1902
US
IV. Provider business mailing address
2815 E CHEVY CHASE DR
GLENDALE CA
91206-1902
US
V. Phone/Fax
- Phone: 818-913-1140
- Fax:
- Phone: 818-913-1140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RABI
U
ALAM
Title or Position: PRESIDENT
Credential: MD
Phone: 818-913-1140