Provider Demographics
NPI:1902244809
Name:RIZKALLA, MIRIAM SAMIER SHAFIK (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:SAMIER SHAFIK
Last Name:RIZKALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9330 STOCKDALE HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3614
Mailing Address - Country:US
Mailing Address - Phone:661-241-6700
Mailing Address - Fax:304-243-3895
Practice Address - Street 1:9330 STOCKDALE HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3614
Practice Address - Country:US
Practice Address - Phone:661-241-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine