Provider Demographics
NPI:1265002273
Name:SHAHID MALIK MD PC
Entity Type:Organization
Organization Name:SHAHID MALIK MD PC
Other - Org Name:SOUTH BAY CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:RAYHAN
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-425-2080
Mailing Address - Street 1:8888 E PINNACLE PEAK RD STE A-4
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3620
Mailing Address - Country:US
Mailing Address - Phone:480-248-4402
Mailing Address - Fax:
Practice Address - Street 1:480 4TH AVE STE 409
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4413
Practice Address - Country:US
Practice Address - Phone:619-425-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty