Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A69076 | CA |
NPI | 1598846834 |
---|---|
Provider Name | Dr. Shams Iqbal |
First Address | Riverside, CA 92501-2971 |
Second Address | Riverside, CA 92501-2971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 17/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H24839 | (02) |