Provider Demographics
NPI:1144660879
Name:SHAHABI-ABNEY, ELNAZ (DO)
Entity type:Individual
Prefix:
First Name:ELNAZ
Middle Name:
Last Name:SHAHABI-ABNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FALKNER DR
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0925
Mailing Address - Country:US
Mailing Address - Phone:949-636-4290
Mailing Address - Fax:949-216-6006
Practice Address - Street 1:8 FALKNER DR
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-0925
Practice Address - Country:US
Practice Address - Phone:949-636-4290
Practice Address - Fax:949-216-6006
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11313204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM