Individual
DR. SHAMMAH IBUKUN IKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2530
Mailing address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2530
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
PTL18713
CA
Other
Enumeration date
05/24/2025
Last updated
09/15/2025
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