Provider Demographics
NPI:1205003027
Name:HASHISH, SHAMEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAMEL
Middle Name:A
Last Name:HASHISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 BLAKESLEE AVE APT 419
Mailing Address - Street 2:CONCENTRA URGENT CARE
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3247
Mailing Address - Country:US
Mailing Address - Phone:347-610-5691
Mailing Address - Fax:
Practice Address - Street 1:6033 W CENTURY BLVD STE 200
Practice Address - Street 2:CONCENTRA URGENT CARE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6440
Practice Address - Country:US
Practice Address - Phone:347-610-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPT 11831208100000X
CAA115082208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation