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General NPI Number Information
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NPI Number | 1760596845
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Entity Type | Individual
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Provider Name | EMILE GEORGE SHENOUDA MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 10132 CALIFORNIA AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-6008
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Country | US
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Telephone | 323-566-4411
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Fax | 323-566-0390
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Provider Business Mailing Address
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Address Line | 10132 CALIFORNIA AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-6008
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Country | US
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Telephone | 310-678-2291
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Fax | 323-566-0390
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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 | A56273
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A56273
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License Number State | CA
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