Provider Demographics
NPI:1184781924
Name:SHAMONKI, JAIME MARIE (MD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:MARIE
Last Name:SHAMONKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13953 PANAY WAY APT 222
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6191
Mailing Address - Country:US
Mailing Address - Phone:310-822-5810
Mailing Address - Fax:
Practice Address - Street 1:1328 22ND ST
Practice Address - Street 2:SAINT JOHN'S HEALTH CENTER, DEPT OF PATHOLOGY
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2032
Practice Address - Country:US
Practice Address - Phone:310-829-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95286207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology