Healthcare Provider Details

I. General information

NPI: 1275855728
Provider Name (Legal Business Name): ZOHREH KOUSHA-SHOAR MD., MPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. ZOHREH F. SHOAR

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 HOLLISTER AVE STE 250
SANTA BARBARA CA
93111-2466
US

IV. Provider business mailing address

5333 HOLLISTER AVE STE 250
SANTA BARBARA CA
93111-2466
US

V. Phone/Fax

Practice location:
  • Phone: 805-879-4240
  • Fax: 805-879-4268
Mailing address:
  • Phone: 805-879-4240
  • Fax: 805-879-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA126688
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberA126688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: