Fadia Zaky Shehata, M.D.
Individual provider Active NPI Anesthesiology Physician · Porterranch, CA
NPI 1104239995 · NPPES record last updated Jun 9, 2014
Key facts
- NPI
- 1104239995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- AFE34770 (CA)
- Practice address
- 19012 Vist Grande Wy
Porterranch, CA 91326 - Phone
- (818) 368-8384
- NPI assigned
- Jun 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AFE34770 | CA | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | AFE34770 | CA | Yes |
Addresses
Primary practice location
19012 Vist Grande Wy
Porterranch, CA 91326
Mailing address
19012 Vist Grande Wy
Porterranch, CA 91326
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.