Provider Demographics
NPI:1891896023
Name:SHAKIR, SHABBIR A (MD)
Entity Type:Individual
Prefix:
First Name:SHABBIR
Middle Name:A
Last Name:SHAKIR
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 1:2808 F ST
Mailing Address - Street 2:E
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1833
Mailing Address - Country:US
Mailing Address - Phone:661-395-0688
Mailing Address - Fax:661-395-3082
Practice Address - Street 1:2808 F ST
Practice Address - Street 2:E
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1833
Practice Address - Country:US
Practice Address - Phone:661-395-0688
Practice Address - Fax:661-395-3082
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A396400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A396400Medicare PIN
A28932Medicare UPIN