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General NPI Number Information
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NPI Number | 1376170100
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Entity Type | Individual
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Provider Name | SHADEE MOATAZ GIURGIUS MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 20409 YORBA LINDA BLVD SUITE K2-265
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City | YORBA LINDA
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State | CA
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Zip | 92886-3042
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Country | US
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Telephone | 562-450-0425
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Fax | 562-947-8839
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Provider Business Mailing Address
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Address Line | 20409 YORBA LINDA BLVD STE K2-265
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City | YORBA LINDA
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State | CA
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Zip | 92886-3042
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Country | US
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Telephone | 562-450-0425
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Fax | 562-947-8839
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A179744
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License Number State | CA
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