Individual
JAMAL SHALABI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
672 SHAFFER ST, CORONA, CA 92879-8887
(337) 244-2252
Mailing address
672 SHAFFER ST, CORONA, CA 92879-8887
(337) 244-2252
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
3311881187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3311881187
CDSS
CA
Enumeration date
12/14/2021
Last updated
12/14/2021
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