Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036142833 | IL |
Y | 207Q00000X | Family Doctor | A143988 | CA |
N | 207Q00000X | Family Doctor | MT206848 | PA |
NPI | 1003229402 |
---|---|
Provider Name | Mohamed Elsharkawy |
First Address | Claremont, CA 91711-6604 |
Second Address | Pomona, CA 91767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 30/12/2019 |