Individual
NAEL M SHAHATTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
399 E HIGHLAND AVE, STE 309, SAN BERNARDINO, CA 92404
(909) 883-9953
(909) 883-2840
Mailing address
22421 BARTON RD # 296, GRAND TERRACE, CA 92313-5008
(909) 883-9953
(909) 883-2840
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A52423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A524230
—
CA
Enumeration date
09/05/2006
Last updated
06/09/2014
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