Provider Demographics
NPI:1922200708
Name:FOOTHILL INDUSTRIAL MEDICAL CLINICS, INC.
Entity Type:Organization
Organization Name:FOOTHILL INDUSTRIAL MEDICAL CLINICS, INC.
Other - Org Name:FOOTHILL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAQUIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-812-0366
Mailing Address - Street 1:6520 N IRWINDALE AVE
Mailing Address - Street 2:
Mailing Address - City:IRWINDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2801
Mailing Address - Country:US
Mailing Address - Phone:626-812-0366
Mailing Address - Fax:626-812-0943
Practice Address - Street 1:6520 N IRWINDALE AVE
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91702-2801
Practice Address - Country:US
Practice Address - Phone:626-812-0366
Practice Address - Fax:626-812-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37904207R00000X
CAA442282083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty