MEDICARE: SHAHIRA S ABDEL-MALEK,MD,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	A36609	CA

General Provider Information

NPI Number	:	1508088840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAHIRA S ABDEL-MALEK,MD,INC.

Provider Business Mailing Address
First Line	:	3100 E FLORENCE AVE
Second Line	:	SUITE 1
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5848
Country	:	US
Telephone Number	:	323-583-4115
Fax Number	:	323-585-8793

Provider Business Practice Location Address
First Line	:	3100 E FLORENCE AVE
Second Line	:	SUITE 1
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5848
Country	:	US
Telephone Number	:	323-583-4115
Fax Number	:	323-585-8793

Authorized Official
Title or Position	:	M.D.
Name	:	DR. SHAHIRA SHAFIK ABDEL-MALEK
Credential	:	M.D.
Telephone Number	:	323-583-4115

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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