Basic Information
Provider Information
NPI: 1316300445
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALSHAIKH
FirstName: RAWAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3210 OAKLEY STATION BLVD
Address2: UNIT 105
City: CINCINNATI
State: OH
PostalCode: 452091190
CountryCode: US
TelephoneNumber: 8454643315
FaxNumber:  
Practice Location
Address1: 8950 VILLA LA JOLLA DR STE C230
Address2:  
City: LA JOLLA
State: CA
PostalCode: 920371712
CountryCode: US
TelephoneNumber: 4242842440
FaxNumber: 4805463134
Other Information
ProviderEnumerationDate: 04/05/2016
LastUpdateDate: 10/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0800XA174932CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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