Provider Demographics
NPI:1588635312
Name:MALIK, SHAHID PERVEZ (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:PERVEZ
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2671
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:
Practice Address - Street 1:2911 N TENAYA WAY STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-342-1244
Practice Address - Fax:702-577-2542
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11635207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NV100508309Medicaid
F45528Medicare UPIN
NVPENDINGMedicaid