Shohreh Nourollah, PA
Physician Assistant in Los Angeles, CA. Individual provider (NPI-1).
NPI number1396954079
StatusActive
Last updated in NPPESMar 6, 2012
Details
- NPI
- 1396954079
- Entity type
- Individual (NPI-1)
- Name
- Shohreh Nourollah
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 21, 2007
- Last updated
- Mar 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA16960 | CA | Yes |
Other names
- Shohreh Nourollah (Former Name)
Practice location
1741 S Bedford StLos Angeles, CA 90035-4320
Phone 310-497-6666
Mailing address
1741 S Bedford StLos Angeles, CA 90035-4320
Phone 310-497-6666
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