Individual
ALMOUTAZ BELLAH SHAKALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
399 E HIGHLAND AVE STE 227, SAN BERNARDINO, CA 92404-3851
(612) 616-3963
Mailing address
5450 JEFFERSON AVE STE 2, CHINO, CA 91710-3522
(909) 882-1210
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39303
IA
207R00000X
Internal Medicine Physician
63294
MN
207R00000X
Internal Medicine Physician
MD-39303
IA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A154138
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2009
Last updated
11/12/2020
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