Healthcare Provider Details

I. General information

NPI: 1437071552
Provider Name (Legal Business Name): MOLLY SHAMIEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W PICO BLVD
LOS ANGELES CA
90015-2410
US

IV. Provider business mailing address

6951 CEDROS AVE
VAN NUYS CA
91405-3802
US

V. Phone/Fax

Practice location:
  • Phone: 213-389-2526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC37659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: