Healthcare Provider Details

I. General information

NPI: 1710164967
Provider Name (Legal Business Name): STEVEN C SHOHAM MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 BALBOA BLVD STE 360
GRANADA HILLS CA
91344
US

IV. Provider business mailing address

10515 BALBOA BLVD STE 360
GRANADA HILLS CA
91344-6346
US

V. Phone/Fax

Practice location:
  • Phone: 818-832-3322
  • Fax: 818-360-9171
Mailing address:
  • Phone: 818-832-3322
  • Fax: 818-360-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN CHARLES SHOHAM
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 818-832-3322