Provider Demographics
NPI:1295832277
Name:ABDEL-MALEK, SHAHIRA SHAFIK (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHIRA
Middle Name:SHAFIK
Last Name:ABDEL-MALEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAHIRA
Other - Middle Name:S
Other - Last Name:MALEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3100 E FLORENCE AVE
Mailing Address - Street 2:#1
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-5848
Mailing Address - Country:US
Mailing Address - Phone:323-583-4115
Mailing Address - Fax:323-584-9089
Practice Address - Street 1:3100 E FLORENCE AVE
Practice Address - Street 2:#1
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5848
Practice Address - Country:US
Practice Address - Phone:323-583-4115
Practice Address - Fax:323-584-9089
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36609208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW21268Medicare UPIN
A28142Medicare UPIN