Provider Demographics
NPI:1669491809
Name:SHAREEF, TAHSEEN NAJMA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHSEEN
Middle Name:NAJMA
Last Name:SHAREEF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11374 MOUNTAIN VIEW AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3830
Mailing Address - Country:US
Mailing Address - Phone:909-203-3825
Mailing Address - Fax:909-799-3888
Practice Address - Street 1:11374 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3830
Practice Address - Country:US
Practice Address - Phone:909-203-3825
Practice Address - Fax:909-799-3888
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G841090Medicaid
G66759Medicare UPIN
CA00G841090Medicaid