Provider Demographics
NPI:1265788947
Name:SHAMMAS, LINA CATHERINE (DO)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:CATHERINE
Last Name:SHAMMAS
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 1:1961 CUMMINGS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1760
Mailing Address - Country:US
Mailing Address - Phone:323-661-2871
Mailing Address - Fax:
Practice Address - Street 1:2006 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1319
Practice Address - Country:US
Practice Address - Phone:818-843-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine