Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A118986 | CA |
NPI | 1225359227 |
---|---|
Provider Name | David Shamouelian |
First Address | Beverly Hills, CA 90210-4303 |
Second Address | Beverly Hills, CA 90212-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 17/03/2018 |