Provider Demographics
NPI:1396090106
Name:IJAZ I ARSHAD MD INC.
Entity type:Organization
Organization Name:IJAZ I ARSHAD MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IJAZ
Authorized Official - Middle Name:I
Authorized Official - Last Name:ARSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-996-0123
Mailing Address - Street 1:2852 CONESTOGA CT
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3193
Mailing Address - Country:US
Mailing Address - Phone:619-840-0649
Mailing Address - Fax:
Practice Address - Street 1:2433 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9599
Practice Address - Country:US
Practice Address - Phone:760-355-4200
Practice Address - Fax:760-565-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69901207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGT783AMedicare PIN