Provider Demographics
NPI:1669677365
Name:RIZVI, SYED MUHAMMAD HAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:MUHAMMAD HAMMAD
Last Name:RIZVI
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 1:901 SAN BERNARDINO RD STE 104
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4993
Mailing Address - Country:US
Mailing Address - Phone:909-946-0844
Mailing Address - Fax:909-982-4770
Practice Address - Street 1:901 SAN BERNARDINO RD STE 104
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4993
Practice Address - Country:US
Practice Address - Phone:909-946-0844
Practice Address - Fax:909-982-4770
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine