Provider Demographics
NPI:1598857815
Name:SHALABI, KAIED ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:KAIED
Middle Name:ALBERTO
Last Name:SHALABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAIED
Other - Middle Name:OTHMAN
Other - Last Name:SHALABI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-1068
Mailing Address - Country:US
Mailing Address - Phone:626-915-1748
Mailing Address - Fax:626-915-2094
Practice Address - Street 1:453 E ARROW HWY
Practice Address - Street 2:UNIT B
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702
Practice Address - Country:US
Practice Address - Phone:626-915-1748
Practice Address - Fax:626-915-2094
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39507208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics