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General NPI Number Information
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NPI Number | 1003106782
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Entity Type | Individual
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Provider Name | ELSHADEY YAYEHYERADE BEKELE
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Gender | Female
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 301-565-4279
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 35TH AVE
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City | OAKLAND
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State | CA
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Zip | 94619-1433
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Country | US
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Telephone | 510-220-8114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD042502
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License Number State | DC
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