Organization Name: | SADEEQ KHAN SADIQ, INC. |
NPI Number: | 1326289737 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SADEEQ KHAN SADIQ (DIRECTOR) |
Mailing Address: | 888 Palm Ave Imperial Beach |
State: | CA US |
Postal Code: | 919321529 |
Phone Number: | 6194230100 |
Fax Number: | 6194230120 |
NPI Enumeration Date: | 03/13/2009 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | A89200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |