Provider Demographics
NPI:1508088840
Name:SHAHIRA S ABDEL-MALEK,MD,INC.
Entity Type:Organization
Organization Name:SHAHIRA S ABDEL-MALEK,MD,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHIRA
Authorized Official - Middle Name:SHAFIK
Authorized Official - Last Name:ABDEL-MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-583-4115
Mailing Address - Street 1:3100 E FLORENCE AVE
Mailing Address - Street 2:SUITE 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:323-585-8793
Practice Address - Street 1:3100 E FLORENCE AVE
Practice Address - Street 2:SUITE 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:323-585-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA366092080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Single Specialty