Provider Demographics
NPI:1306180112
Name:MARVI IQBAL MD INC
Entity Type:Organization
Organization Name:MARVI IQBAL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVI
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-670-1261
Mailing Address - Street 1:5471 LA PALMA AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1745
Mailing Address - Country:US
Mailing Address - Phone:714-670-1261
Mailing Address - Fax:714-670-2873
Practice Address - Street 1:5471 LA PALMA AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1745
Practice Address - Country:US
Practice Address - Phone:714-670-1261
Practice Address - Fax:714-670-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98780207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty