Shuham, Ellen

Shuham, Ellen is an individual health care provider with primary practice located at 18661 Devonshire St , Northridge CA 91324. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Shuham, Ellen can be contacted via phone (818) 368-1234.

Contact Information

Primary practice address
18661 Devonshire St Northridge CA 91324
Fax: (818) 363-3161
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT6899TPA California

Profile Details

NPI number 1629127519
LBN Legal business name Shuham, Ellen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Nov 17th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629127519 NPPES
California MEDICAID SD0068990

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