Provider Demographics
NPI:1295864395
Name:QASEEM, TAHIR (MD)
Entity Type:Individual
Prefix:
First Name:TAHIR
Middle Name:
Last Name:QASEEM
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 1:1003 E FLORIDA AVE STE 101
Mailing Address - Street 2:1003 E FLORIDA AVE STE 101
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-6666
Mailing Address - Country:US
Mailing Address - Phone:951-652-2252
Mailing Address - Fax:951-658-6476
Practice Address - Street 1:1003 E FLORIDA AVE STE 101
Practice Address - Street 2:1003 E FLORIDA AVE STE 101
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-9410
Practice Address - Country:US
Practice Address - Phone:951-652-2252
Practice Address - Fax:951-658-6476
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM99101207RG0100X
CAC52324207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Z3931Medicaid
NM000Z3931Medicaid
G87656Medicare UPIN