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General NPI Number Information
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NPI Number | 1104183961
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Entity Type | Individual
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Provider Name | FERDINAND JAMIL SHAMIYEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 11525 BROOKSHIRE AVE STE 302
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City | DOWNEY
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State | CA
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Zip | 90241-4982
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Country | US
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Telephone | 562-904-2821
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Fax | 562-904-2826
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Provider Business Mailing Address
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Address Line | 13322 MILLER AVE
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City | NORWALK
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State | CA
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Zip | 90650-3365
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Country | US
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Telephone |
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 134648
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License Number State | CA
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