MEDICARE: DR. FATIMA SHAFI

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	1223G0001X	General Practice Dentistry	DDS110219	CA
2	1223G0001X	General Practice Dentistry	7094	NV

General Provider Information

NPI Number	:	1396231759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FATIMA SHAFI

Provider Business Mailing Address
First Line	:	3084 ST GEORGE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2517
Country	:	US
Telephone Number	:	847-505-6019
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 FAIR OAKS AVE
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-2605
Country	:	US
Telephone Number	:	626-593-0053
Fax Number	:

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

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	07/11/2024

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Directions to “ DR. FATIMA SHAFI ” Practice Location

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