Provider Demographics
NPI:1689156200
Name:SUBHI GHANI SHARIF MD INC
Entity Type:Organization
Organization Name:SUBHI GHANI SHARIF MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SUBHI
Authorized Official - Middle Name:GHANI
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-658-7455
Mailing Address - Street 1:750 E LATHAM AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4370
Mailing Address - Country:US
Mailing Address - Phone:951-658-7455
Mailing Address - Fax:951-658-9795
Practice Address - Street 1:750 E LATHAM AVE STE 2
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4370
Practice Address - Country:US
Practice Address - Phone:951-658-7455
Practice Address - Fax:951-658-9795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC042984261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care