Basic Information
Provider Information
NPI: 1821301086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALSHAREEF
FirstName: AMEEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1503 N IMPERIAL AVE
Address2: SUITE 204
City: EL CENTRO
State: CA
PostalCode: 922436301
CountryCode: US
TelephoneNumber: 3046911300
FaxNumber: 3046911375
Practice Location
Address1: 1503 N IMPERIAL AVE
Address2: SUITE 204
City: EL CENTRO
State: CA
PostalCode: 922436301
CountryCode: US
TelephoneNumber: 7603392802
FaxNumber: 7603392829
Other Information
ProviderEnumerationDate: 07/16/2010
LastUpdateDate: 05/14/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XA123164CAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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