Organization Name: | JAMSHEED JAMES SHAMLOO MD INC |
NPI Number: | 1154645398 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMSHEED J SHAMLOO (OWNER) |
Mailing Address: | 1023 S Mount Vernon Ave Colton |
State: | CA US |
Postal Code: | 923244202 |
Phone Number: | 9094228015 |
Fax Number: | 9094220625 |
NPI Enumeration Date: | 03/17/2010 |
NPI Last Update Date: | 06/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A89604 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |