Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 55725 | CA |
NPI | 1073714218 |
---|---|
Provider Name | Dr. Shama Currimbhoy |
First Address | Encinitas, CA 92024-2874 |
Second Address | Carlsbad, CA 92009-4211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 15/12/2021 |