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Individual

JOHN K SHAIB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9040 TELEGRAPH RD, SITE 100, DOWNEY, CA 90240-2393
(562) 861-0954
(562) 861-3739
Mailing address
PO BOX 486, ARTESIA, CA 90702-0486
(562) 861-0954
(562) 861-3739

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G40205
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G402050
BLUE SHIELD #
CA
05
00G402050
CA
01
00G402051
BLUE SHIELD #
CA
01
015521
HEALTH NET ID #
01
110060907
RAILROAD
01
P00357366
RAILROAD
Enumeration date
06/02/2006
Last updated
03/16/2015
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