MEDICARE: HEBA MARZOUK AL-SHOUBAKI PA-C

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	363A00000X	Physician Assistant	PA58597	CA

General Provider Information

NPI Number	:	1548867666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEBA MARZOUK AL-SHOUBAKI PA-C

Provider Business Mailing Address
First Line	:	2501 E CHAPMAN AVE STE 306
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92869-3204
Country	:	US
Telephone Number	:	714-628-3230
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 E CHAPMAN AVE STE 306
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92869-3204
Country	:	US
Telephone Number	:	714-628-3230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	02/09/2026

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Directions to “ HEBA MARZOUK AL-SHOUBAKI PA-C” Practice Location

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