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General NPI Number Information
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NPI Number | 1073599254
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Entity Type | Individual
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Provider Name | SHADI AMINOLOLAMA-SHAKERI M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4860 Y ST SUITE 3100
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City | SACRAMENTO
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State | CA
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Zip | 95817-2307
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Country | US
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Telephone | 916-734-5195
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Fax | 916-734-6548
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Provider Business Mailing Address
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Address Line | 26 SAXTON CT
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2603
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Country | US
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Telephone | 415-377-8341
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Fax | 916-734-6548
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | A80023
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License Number State | CA
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