Provider Demographics
NPI:1144370354
Name:YOONESSI, M.D, SHAMS (MD)
Entity type:Individual
Prefix:
First Name:SHAMS
Middle Name:
Last Name:YOONESSI, M.D
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAMS
Other - Middle Name:
Other - Last Name:ALEMOZAFFAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6790 CREST RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90731-5495
Mailing Address - Country:US
Mailing Address - Phone:310-541-3937
Mailing Address - Fax:
Practice Address - Street 1:731 S BEACON ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3738
Practice Address - Country:US
Practice Address - Phone:310-732-5889
Practice Address - Fax:310-732-5890
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50483208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics