Provider Demographics
NPI:1518009034
Name:M ILBEIGI AND ASSOC MD INC
Entity Type:Organization
Organization Name:M ILBEIGI AND ASSOC MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSTAFA
Authorized Official - Middle Name:SHAHROKH
Authorized Official - Last Name:ILBEIGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-242-3939
Mailing Address - Street 1:18400 US HIGHWAY 18 STE A
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2306
Mailing Address - Country:US
Mailing Address - Phone:760-242-3939
Mailing Address - Fax:760-242-3232
Practice Address - Street 1:18400 US HIGHWAY 18 STE A
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2306
Practice Address - Country:US
Practice Address - Phone:760-242-3939
Practice Address - Fax:760-242-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABB216BMedicare PIN
CABB216AMedicare PIN
CABB216BMedicare PIN