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NPI Code Detail

MEDICARE: MOHAMMED SHAH

MEDICARE: MOHAMMED SHAH
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
1171M00000XCase Manager/Care CoordinatorCA

General Provider Information

NPI Number : 1508720061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMED SHAH
Provider Business Mailing Address
First Line : 340 N MADISON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-3504
Country : US
Telephone Number : 213-631-0612
Fax Number :
Provider Business Practice Location Address
First Line : 340 N MADISON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-3504
Country : US
Telephone Number : 213-631-0612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ MOHAMMED SHAH ” Practice Location

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