Provider Demographics
NPI:1184676785
Name:ELSAKR, MAGDY SHOUKRY (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:SHOUKRY
Last Name:ELSAKR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 SYLVAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9211
Mailing Address - Country:US
Mailing Address - Phone:209-338-0292
Mailing Address - Fax:209-338-0298
Practice Address - Street 1:2336 SYLVAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9211
Practice Address - Country:US
Practice Address - Phone:209-338-0292
Practice Address - Fax:209-338-0298
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45724174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A457240Medicaid
CA00A457240Medicaid
CAAP956ZMedicare PIN