MEDICARE: DR. TASNIM ESMAIL SHAMJI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A065915	CA

General Provider Information

NPI Number	:	1386815108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASNIM ESMAIL SHAMJI M.D.

Provider Business Mailing Address
First Line	:	11977 DOROTHY ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5302
Country	:	US
Telephone Number	:	310-826-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	11977 DOROTHY ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5302
Country	:	US
Telephone Number	:	310-826-3248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	03/19/2008

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