Provider Demographics
NPI:1861506636
Name:QURESHI, HUMAYUN (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMAYUN
Middle Name:
Last Name:QURESHI
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 1:28125 BRADLEY RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2248
Mailing Address - Country:US
Mailing Address - Phone:951-666-1243
Mailing Address - Fax:951-679-3133
Practice Address - Street 1:28125 BRADLEY RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2248
Practice Address - Country:US
Practice Address - Phone:951-666-1243
Practice Address - Fax:951-679-3133
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51284207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-3630862OtherTIN
CA00C512841Medicare PIN