Provider Demographics
NPI:1114041316
Name:SHAMS IQBAL INC
Entity Type:Organization
Organization Name:SHAMS IQBAL INC
Other - Org Name:ASTHMA AND ALLERGY MEDICA,L GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIGHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:9513-367-1060
Mailing Address - Street 1:3600 LIME ST STE 714
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-2978
Mailing Address - Country:US
Mailing Address - Phone:951-367-1060
Mailing Address - Fax:951-686-5282
Practice Address - Street 1:3600 LIME ST STE 714
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-2978
Practice Address - Country:US
Practice Address - Phone:951-367-1060
Practice Address - Fax:951-686-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69076207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A69076Medicare ID - Type Unspecified
CAH24839Medicare UPIN