Provider Demographics
NPI:1871760918
Name:SHAMLOO, BAHMAN BEN (MD)
Entity type:Individual
Prefix:DR
First Name:BAHMAN
Middle Name:BEN
Last Name:SHAMLOO
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 1:8631 W 3RD ST STE 815E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-246-2358
Mailing Address - Fax:424-285-8534
Practice Address - Street 1:8631 W 3RD ST STE 815E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-246-2358
Practice Address - Fax:424-285-8534
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103444207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology