Provider Demographics
NPI:1194217539
Name:ALSHAMMARY, MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:ALSHAMMARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMED
Other - Middle Name:
Other - Last Name:KHALID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:250 E CHASE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-6305
Mailing Address - Country:US
Mailing Address - Phone:619-499-5006
Mailing Address - Fax:844-499-5006
Practice Address - Street 1:250 E CHASE AVE STE 109
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6305
Practice Address - Country:US
Practice Address - Phone:619-499-5006
Practice Address - Fax:844-499-5006
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301502511207R00000X
CAA176049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine