Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A90583 | CA |
N | 2084N0600X | Clinical Neurophysiologist | A90583 | CA |
NPI | 1508065947 |
---|---|
Provider Name | Dr. Shamsha Velani Doran |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90403-5609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 16/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A905830 | (05) | CA |