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General NPI Number Information
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NPI Number | 1467732297
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Entity Type | Organization
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Legal Business Name | SHASHITA INAMDAR MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 5060 SHOREHAM PL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92122-5904
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Country | US
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Telephone | 858-221-0344
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Fax | 858-248-4262
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Provider Business Mailing Address
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Address Line | 5060 SHOREHAM PL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92122-5904
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Country | US
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Telephone | 858-221-0344
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Fax | 858-248-4262
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TONI RODRIGUEZ
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Credential |
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Telephone | 858-221-0344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A102089
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License Number State | CA
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