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General NPI Number Information
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NPI Number | 1306734082
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Entity Type | Individual
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Provider Name | SHAWDEE ROXANE MASHAYEKH DPM
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Gender | Female
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 11201 BENTON ST
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City | LOMA LINDA
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State | CA
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Zip | 92357-1000
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Country | US
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Telephone | 909-825-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 1352 CAMINO DEL SUR
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City | SAN DIMAS
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State | CA
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Zip | 91773-4406
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Country | US
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Telephone | 626-506-5160
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | EL7197
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License Number State | CA
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