Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 20A16977 | CA |
NPI | 1013442342 |
---|---|
Provider Name | Saad Farooq |
First Address | Hemet, CA 92543 |
Second Address | Hemet, CA 92543-3083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2017 |
Last Update Date | 03/05/2021 |