MEDICARE: DR. HALA Z. SHAKIR

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	122300000X	Dentist	55755	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871798009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HALA Z. SHAKIR

Provider Business Mailing Address
First Line	:	10804 RISING SMOKE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4677
Country	:	US
Telephone Number	:	714-480-3000
Fax Number	:	714-571-3560

Provider Business Practice Location Address
First Line	:	69160 RAMON ROAD
Second Line	:	STUITE #100
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3343
Country	:	US
Telephone Number	:	760-969-5469
Fax Number	:	760-770-0280

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	07/09/2007

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