Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A11313 | CA |
Y | 207Q00000X | Family Doctor | 20A11313 | CA |
NPI | 1144660879 |
---|---|
Provider Name | Elnaz Shahabi-Abney |
First Address | Ladera Ranch, CA 92694-0925 |
Second Address | Ladera Ranch, CA 92694-0925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 26/06/2013 |