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General NPI Number Information
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NPI Number | 1477686616
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Entity Type | Individual
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Provider Name | ELENA SHABASH M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 16111 PLUMMER ST
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City | NORTH HILLS
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State | CA
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Zip | 91343-2036
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Country | US
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Telephone | 818-891-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 8614 CASABA AVE
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City | WINNETKA
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State | CA
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Zip | 91306-1309
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Country | US
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Telephone | 302-373-6084
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C10007157
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C131670
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License Number State | CA
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