Provider Demographics
NPI:1376705418
Name:LAWANDY, SHOKRY NABEEL (DO)
Entity type:Individual
Prefix:
First Name:SHOKRY
Middle Name:NABEEL
Last Name:LAWANDY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:19069 VAN BUREN BLVD
Mailing Address - Street 2:SUITE 114 UNIT # 422
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508
Mailing Address - Country:US
Mailing Address - Phone:714-402-4017
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVENUE
Practice Address - Street 2:SUITE 220
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608
Practice Address - Country:US
Practice Address - Phone:916-241-9677
Practice Address - Fax:916-436-4288
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2024-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10863207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376705418OtherNPI