Healthcare Provider Details

I. General information

NPI: 1780400747
Provider Name (Legal Business Name): MAHER SHOKR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8832 SYRACUSE AVE
ANAHEIM CA
92804-6229
US

IV. Provider business mailing address

8832 SYRACUSE AVE
ANAHEIM CA
92804-6229
US

V. Phone/Fax

Practice location:
  • Phone: 714-724-2322
  • Fax:
Mailing address:
  • Phone: 714-724-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: