Provider Demographics
NPI:1275610503
Name:FAROOQI, MUFTI SAADAT AHMED (MD)
Entity Type:Individual
Prefix:MR
First Name:MUFTI SAADAT
Middle Name:AHMED
Last Name:FAROOQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 E MARINERS CIR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0848
Mailing Address - Country:US
Mailing Address - Phone:559-434-0281
Mailing Address - Fax:559-434-0281
Practice Address - Street 1:1332 W HERNDON AVE
Practice Address - Street 2:SUITE NUMBER 100
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-7118
Practice Address - Country:US
Practice Address - Phone:559-435-1979
Practice Address - Fax:559-434-9988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69294207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH92836Medicare UPIN
CA00A692940Medicare ID - Type Unspecified