Provider Demographics
NPI:1578547519
Name:BEGUM, NASIMA (MD)
Entity Type:Individual
Prefix:
First Name:NASIMA
Middle Name:
Last Name:BEGUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3304
Mailing Address - Country:US
Mailing Address - Phone:626-851-8880
Mailing Address - Fax:626-851-8001
Practice Address - Street 1:935 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3304
Practice Address - Country:US
Practice Address - Phone:626-851-8880
Practice Address - Fax:626-851-8001
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54089207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0059520Medicaid
CA440003210Medicare PIN
CAGR0059520Medicaid
CAWA54089BMedicare PIN
CAH5906Medicare PIN
CAW15222Medicare PIN
CABT289AMedicare PIN