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Organization
SHAKER MEDICAL CORPORATION
Active
Organization
SHAKER MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH S GENDY-SHAKER MD (PRESIDENT)
(951) 977-1082
Entity
Organization
Contact information
Practice address
1752 E LUGONIA AVE STE 117-1027, REDLANDS, CA 92374-2730
(951) 977-1082
Mailing address
1752 E LUGONIA AVE STE 117-1027, REDLANDS, CA 92374-2730
(951) 977-1082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
Primary
—
NULL
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
11/06/2024
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