Provider Demographics
NPI:1942285879
Name:IQBAL, RASHID (MD)
Entity Type:Individual
Prefix:
First Name:RASHID
Middle Name:
Last Name:IQBAL
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 1:1261 TRAVIS BLVD
Mailing Address - Street 2:STE 170
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4897
Mailing Address - Country:US
Mailing Address - Phone:707-399-9200
Mailing Address - Fax:
Practice Address - Street 1:1261 TRAVIS BLVD
Practice Address - Street 2:STE 170
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4897
Practice Address - Country:US
Practice Address - Phone:707-399-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43154207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431541Medicaid
CA00A431541Medicaid
CA00A431541Medicare ID - Type Unspecified