1114041316 NPI number — SHAMS IQBAL INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114041316 NPI number — SHAMS IQBAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHAMS IQBAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASTHMA AND ALLERGY MEDICA,L GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114041316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 LIME ST STE 714
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92501-2978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-367-1060
Provider Business Mailing Address Fax Number:
951-686-5282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 LIME ST STE 714
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92501-2978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-367-1060
Provider Business Practice Location Address Fax Number:
951-686-5282
Provider Enumeration Date:
03/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHERE
Authorized Official First Name:
NIGHAT
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
95133671060

Provider Taxonomy Codes

  • Taxonomy code: 207KA0200X , with the licence number:  A69076 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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