Provider Demographics
NPI:1982771655
Name:SHEHATA, MABROOK LAWANDY (MD)
Entity Type:Individual
Prefix:DR
First Name:MABROOK
Middle Name:LAWANDY
Last Name:SHEHATA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2660 CRIMSON CANYON DR STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0846
Mailing Address - Country:US
Mailing Address - Phone:661-327-0692
Mailing Address - Fax:661-327-0873
Practice Address - Street 1:3900 SAN DIMAS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1458
Practice Address - Country:US
Practice Address - Phone:661-327-8000
Practice Address - Fax:866-265-2073
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2024-05-07
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Provider Licenses
StateLicense IDTaxonomies
CAA97348207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine