# ALMOUTAZ BELLAH SHAKALLY MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821612565
- **Authorized official:** ALMOUTAZ BELLAH SHAKALLY MD (OWNER)
- **Authorized official phone:** (951) 444-7006

## Contact information

- **Practice address:** 802 MAGNOLIA AVE STE 200, CORONA, CA 92879-3144
- **Practice address phone:** (951) 444-7006
- **Practice address fax:** (909) 247-3340
- **Mailing address:** 802 MAGNOLIA AVE STE 200, CORONA, CA 92879-3144
- **Mailing address phone:** (951) 444-7006
- **Mailing address fax:** (909) 247-3340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/28/2020
- **Last updated:** 04/25/2024