Healthcare Provider Details

I. General information

NPI: 1134420144
Provider Name (Legal Business Name): SHILA SHAFII NOORI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 12/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BARBOZA ST
MENDOTA CA
93640-1901
US

IV. Provider business mailing address

650 S ZEDIKER AVE
PARLIER CA
93648-2666
US

V. Phone/Fax

Practice location:
  • Phone: 559-655-5000
  • Fax:
Mailing address:
  • Phone: 800-492-4227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA118489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: