Healthcare Provider Details

I. General information

NPI: 1821301086
Provider Name (Legal Business Name): AMEEN ALSHAREEF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 08/29/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 W. PICO AVE SUITE 1
EL CENTRO CA
92243
US

IV. Provider business mailing address

1503 N IMPERIAL AVE SUITE 204
EL CENTRO CA
92243-6301
US

V. Phone/Fax

Practice location:
  • Phone: 714-767-5659
  • Fax: 760-970-4373
Mailing address:
  • Phone: 304-691-1300
  • Fax: 304-691-1375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA123164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: