Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 148260 | CA |
NPI | 1023391166 |
---|---|
Provider Name | Sohaib Tariq |
First Address | El Centro, CA 92243-3274 |
Second Address | El Centro, CA 92243-3274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2011 |
Last Update Date | 07/06/2017 |