Provider Demographics
NPI:1073790713
Name:NOUCHIAN, SHEILA (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:NOUCHIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4067 TRANSPORT ST
Mailing Address - Street 2:SUITE #B
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4914
Mailing Address - Country:US
Mailing Address - Phone:650-251-9119
Mailing Address - Fax:
Practice Address - Street 1:4067 TRANSPORT ST
Practice Address - Street 2:SUITE #B
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4914
Practice Address - Country:US
Practice Address - Phone:650-384-0986
Practice Address - Fax:650-251-9119
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073790713OtherNPI