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Mr. Shashonk Illam
Student in an Organized Health Care Education/Training Program in Newport Beach, California
NPI 1104432228

Shashonk Illam is a Student in an Organized Health Care Education/Training Program based in Redlands, CA. Shashonk Illam practices in Newport Beach, CA. The NPI Number for Shashonk Illam is 1104432228 and holds a License No. (California).

The current practice location address for Shashonk Illam is 4700 Von Karman Ave Ste 102, Newport Beach, CA and can be reached out via phone at 949-743-1457.

Location: 4700 Von Karman Ave Ste 102, Newport Beach, CA, 92373-5481
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104432228
Provider Name
Shashonk Illam
Credential
Provider Entity Type
Individual
Gender
Male
Address
4700 Von Karman Ave Ste 102, Newport Beach, CA, 92373-5481
Phone Number
949-743-1457
Fax Number
Provider Enumeration Date
09/23/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4700 Von Karman Ave Ste 102
City
Newport Beach
State
California
Zip
92660-2194
Phone Number
949-743-1457
Fax Number
person
Provider Business Mailing Address Details
Address
4700 Von Karman Ave Ste 102
City
Newport Beach
State
California
Zip
92660-2194
Phone Number
949-743-1457
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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