Individual
IBRAHIM SHAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-0103
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
01/19/2024
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