Provider Demographics
NPI:1891307914
Name:GHAUS, SHAABAN
Entity Type:Individual
Prefix:
First Name:SHAABAN
Middle Name:
Last Name:GHAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 THORNTON AVE APT 57
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5647
Mailing Address - Country:US
Mailing Address - Phone:925-350-9035
Mailing Address - Fax:
Practice Address - Street 1:39155 LIBERTY ST STE E500
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1516
Practice Address - Country:US
Practice Address - Phone:510-574-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program