Provider Demographics
NPI:1386229433
Name:SHIFA COMMUNITY CLINIC
Entity Type:Organization
Organization Name:SHIFA COMMUNITY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAGUFTA
Authorized Official - Middle Name:
Authorized Official - Last Name:YASMEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-873-3734
Mailing Address - Street 1:PO BOX 189083
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-9083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:419 V ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1252
Practice Address - Country:US
Practice Address - Phone:916-441-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty