Provider Demographics
NPI:1366642522
Name:SHALABY, MOHSEN N (MD)
Entity type:Individual
Prefix:
First Name:MOHSEN
Middle Name:N
Last Name:SHALABY
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 1:1023 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4510
Mailing Address - Country:US
Mailing Address - Phone:951-599-8403
Mailing Address - Fax:951-766-0930
Practice Address - Street 1:1023 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4510
Practice Address - Country:US
Practice Address - Phone:951-599-8403
Practice Address - Fax:951-766-0930
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine