Provider Demographics
NPI:1407030075
Name:SHAMMAS, ABRAHAM V (MD)
Entity Type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:V
Last Name:SHAMMAS
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 1:1341 SOUTH GRAND AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740
Mailing Address - Country:US
Mailing Address - Phone:626-335-1259
Mailing Address - Fax:626-963-2855
Practice Address - Street 1:1341 SOUTH GRAND AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740
Practice Address - Country:US
Practice Address - Phone:626-335-1259
Practice Address - Fax:626-963-2855
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45941207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology