Provider Demographics
NPI:1023392966
Name:H SHAMMAS MD INC
Entity Type:Organization
Organization Name:H SHAMMAS MD INC
Other - Org Name:SHAMMAS EYE MEDICAL CENTER DOWNEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MILKIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:310-638-9391
Mailing Address - Street 1:3510 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2010
Mailing Address - Country:US
Mailing Address - Phone:310-638-9391
Mailing Address - Fax:310-603-8749
Practice Address - Street 1:8409 FLORENCE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3962
Practice Address - Country:US
Practice Address - Phone:310-638-9391
Practice Address - Fax:310-603-8749
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H SHAMMAS MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAW1243207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW1243Medicare PIN