Provider Demographics
NPI:1184069239
Name:BAJWA, ERUM IQBAL (MD,)
Entity type:Individual
Prefix:
First Name:ERUM
Middle Name:IQBAL
Last Name:BAJWA
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:ERUM
Other - Middle Name:
Other - Last Name:IQBAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2761 RAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5163
Mailing Address - Country:US
Mailing Address - Phone:805-341-2440
Mailing Address - Fax:
Practice Address - Street 1:1140 W LA VETA AVE STE 430
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4226
Practice Address - Country:US
Practice Address - Phone:714-543-5555
Practice Address - Fax:714-543-5585
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135570207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine