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Individual

DR. RAZEQ ABDUL SHETAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2030 COFFEE RD, SUITE B-1, MODESTO, CA 95355-2413
(209) 578-1200
(209) 578-3757
Mailing address
288 W SANTOS AVE, RIPON, CA 95366-9337
(209) 599-6018
(209) 599-6018

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A55408
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A554081
CA
Enumeration date
08/10/2005
Last updated
12/22/2021
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