Gendy-Shaker, Elizabeth S

Gendy-Shaker, Elizabeth S is an individual health care provider with primary practice located at 1690 Barton Rd Ste 104 , Redlands CA 92373-4230. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Pulmonology. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is her primary health care specialty. Gendy-Shaker, Elizabeth S can be contacted via phone (909) 795-4747.

Contact Information

Primary practice address
1690 Barton Rd Ste 104 Redlands CA 92373-4230
Phone: (909) 795-4747
Fax: (909) 793-8146
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 45113 Arizona
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A97366 California
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 45113 Arizona
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X A97366 California

Profile Details

NPI number 1992912950
LBN Legal business name Gendy-Shaker, Elizabeth S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Nov 29th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992912950 NPPES
Arizona MEDICAID 664353

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