Provider Demographics
NPI:1700010030
Name:EL MOKADEM, HESHAM MOHAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:HESHAM
Middle Name:MOHAMED
Last Name:EL MOKADEM
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 1:3837 SHADBUSH DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8115
Mailing Address - Country:US
Mailing Address - Phone:858-361-5243
Mailing Address - Fax:
Practice Address - Street 1:3975 JACKSON ST STE 110
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3946
Practice Address - Country:US
Practice Address - Phone:951-788-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107687207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology