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General NPI Number Information
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NPI Number | 1518490549
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Entity Type | Organization
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Legal Business Name | SHOLEH SHAHINFAR, SPEECH LANGUAGE PATHOLOGY INC
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 3300 IRVINE AVE SUITE 111
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3109
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Country | US
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Telephone | 240-876-4855
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Fax | 949-250-9485
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Provider Business Mailing Address
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Address Line | 3300 IRVINE AVE SUITE 111
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3109
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Country | US
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Telephone | 240-876-4855
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Fax |
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Authorized Official
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Title or Position | FOUNDER/SPEECH LANGUAGE PATHOLOGIST
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Name | SHOLEH SHAHINFAR
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Credential | MA. CCC-SLP
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Telephone | 240-876-4855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18481
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License Number State | CA
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