Provider Demographics
NPI:1902534951
Name:SHOKRALLA, MARGERIT (FNP)
Entity Type:Individual
Prefix:
First Name:MARGERIT
Middle Name:
Last Name:SHOKRALLA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-8555
Mailing Address - Country:US
Mailing Address - Phone:818-277-8418
Mailing Address - Fax:
Practice Address - Street 1:1700 E CESAR CHAVEZ AVE
Practice Address - Street 2:UNIT 3900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2414
Practice Address - Country:US
Practice Address - Phone:323-307-0800
Practice Address - Fax:323-307-0803
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily