Provider Demographics
NPI:1386815108
Name:SHAMJI, TASNIM ESMAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:TASNIM
Middle Name:ESMAIL
Last Name:SHAMJI
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 1:11977 DOROTHY ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5302
Mailing Address - Country:US
Mailing Address - Phone:310-826-3248
Mailing Address - Fax:
Practice Address - Street 1:11977 DOROTHY ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5302
Practice Address - Country:US
Practice Address - Phone:310-826-3248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065915207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine