Provider Demographics
NPI:1790886869
Name:IQBAL, RAZA (MD)
Entity Type:Individual
Prefix:
First Name:RAZA
Middle Name:
Last Name:IQBAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:21520 YORBA LINDA BLVD
Mailing Address - Street 2:SUITE G 558
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3762
Mailing Address - Country:US
Mailing Address - Phone:714-896-9697
Mailing Address - Fax:714-896-8757
Practice Address - Street 1:21520 YORBA LINDA BLVD
Practice Address - Street 2:SUITE G 558
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3762
Practice Address - Country:US
Practice Address - Phone:714-896-9697
Practice Address - Fax:714-896-8757
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA53318207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG17929Medicare UPIN
CAHA53318AMedicare PIN