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General NPI Number Information
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NPI Number | 1174078315
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Entity Type | Organization
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Legal Business Name | SHAIDA BEHNAM MD INC
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 1010 CASS ST STE D3
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City | MONTEREY
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State | CA
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Zip | 93940
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Country | US
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Telephone | 831-901-3691
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Fax | 831-901-3706
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Provider Business Mailing Address
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Address Line | 1010 CASS ST STE D3
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City | MONTEREY
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State | CA
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Zip | 93940-4515
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Country | US
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Telephone | 831-901-3691
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Fax | 831-901-3706
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAIDA BEHNAM
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Credential | MD
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Telephone | 925-640-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A82694
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License Number State | CA
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