Provider Demographics
NPI:1679031991
Name:KAMRAN QURESHI MD INC
Entity Type:Organization
Organization Name:KAMRAN QURESHI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-765-1023
Mailing Address - Street 1:27605 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-8456
Mailing Address - Country:US
Mailing Address - Phone:951-765-1023
Mailing Address - Fax:951-925-3785
Practice Address - Street 1:2589 W FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-4615
Practice Address - Country:US
Practice Address - Phone:951-765-1023
Practice Address - Fax:951-925-3785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A492830Medicaid
CA00A492830OtherMEDICARE ID
CAF90616OtherMEDICARE UPIN