Healthcare Provider Details

I. General information

NPI: 1932283215
Provider Name (Legal Business Name): KAMAL E SHAMASH MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 CAMPUS DRIVE #112
DALY CITY CA
94015
US

IV. Provider business mailing address

901 CAMPUS DRIVE #112
DALY CITY CA
94015
US

V. Phone/Fax

Practice location:
  • Phone: 610-991-1842
  • Fax: 610-991-3367
Mailing address:
  • Phone: 610-991-1842
  • Fax: 610-991-3367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAMAL E SHAMASH
Title or Position: PRESIDENT
Credential: MD
Phone: 650-991-1842