Healthcare Provider Details

I. General information

NPI: 1003720384
Provider Name (Legal Business Name): SHAMIHA ANOWAR MALIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S BEAUDRY AVE
LOS ANGELES CA
90017-1466
US

IV. Provider business mailing address

7519 BELLINGHAM AVE
NORTH HOLLYWOOD CA
91605-3675
US

V. Phone/Fax

Practice location:
  • Phone: 213-241-6131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: