Provider Demographics
NPI:1962745265
Name:SHWEIKEH, FARIS (MD)
Entity type:Individual
Prefix:DR
First Name:FARIS
Middle Name:
Last Name:SHWEIKEH
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 1:6311 PEONY CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8521
Mailing Address - Country:US
Mailing Address - Phone:951-522-3615
Mailing Address - Fax:
Practice Address - Street 1:1010 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1806
Practice Address - Country:US
Practice Address - Phone:805-546-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2024-05-18
Deactivation Date:2014-11-18
Deactivation Code:
Reactivation Date:2015-06-23
Provider Licenses
StateLicense IDTaxonomies
CAA195328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine