Provider Demographics
NPI:1538360490
Name:SHAHAMATI, FARIMA (PT,OMD)
Entity type:Individual
Prefix:
First Name:FARIMA
Middle Name:
Last Name:SHAHAMATI
Suffix:
Gender:F
Credentials:PT,OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2180 S BEVERLY GLEN BLVD
Mailing Address - Street 2:#117
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6048
Mailing Address - Country:US
Mailing Address - Phone:310-203-9292
Mailing Address - Fax:310-201-5018
Practice Address - Street 1:7040 TRASK AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2622
Practice Address - Country:US
Practice Address - Phone:714-900-1439
Practice Address - Fax:714-890-6012
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 3471171100000X
CAPT11796225100000X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner