Healthcare Provider Details

I. General information

NPI: 1134778178
Provider Name (Legal Business Name): MOHAMAD BELAL SHARIF DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR STE W300
PALM SPRINGS CA
92262-4809
US

IV. Provider business mailing address

79405 HIGHWAY 111 STE 9-469
LA QUINTA CA
92253-8300
US

V. Phone/Fax

Practice location:
  • Phone: 760-565-5545
  • Fax: 760-424-5578
Mailing address:
  • Phone: 760-565-5545
  • Fax: 760-424-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberEL6940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: