Healthcare Provider Details

I. General information

NPI: 1093837692
Provider Name (Legal Business Name): SHEELAH MUHAMMAD PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15206 PARTHENIA ST
NORTH HILLS CA
91343-5305
US

IV. Provider business mailing address

15206 PARTHENIA ST
NORTH HILLS CA
91343-5305
US

V. Phone/Fax

Practice location:
  • Phone: 818-895-3100
  • Fax: 818-893-9464
Mailing address:
  • Phone: 818-895-3100
  • Fax: 818-893-9464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA11414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: