Provider Demographics
NPI:1073754412
Name:ASGAR, MIRIAM SHABINA (MA)
Entity Type:Individual
Prefix:MISS
First Name:MIRIAM
Middle Name:SHABINA
Last Name:ASGAR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23293 SOUTH POINTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLA
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-770-5843
Mailing Address - Fax:949-770-9546
Practice Address - Street 1:23293 S POINTE DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1447
Practice Address - Country:US
Practice Address - Phone:949-770-5843
Practice Address - Fax:949-770-9546
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist