Healthcare Provider Details

I. General information

NPI: 1154594968
Provider Name (Legal Business Name): SHANI IFE MUHAMMAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANI IFE RITCHEY MD

II. Dates (important events)

Enumeration Date: 04/12/2008
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S ZEDIKER AVE BLD 3
PARLIER CA
93648-2666
US

IV. Provider business mailing address

121 BARBOZA ST
MENDOTA CA
93640-1901
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-6618
  • Fax:
Mailing address:
  • Phone: 559-655-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA113269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: