Provider Demographics
NPI:1952400871
Name:FAZEELA H BAQAI MD INC
Entity Type:Organization
Organization Name:FAZEELA H BAQAI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAZEELA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAQAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-552-1546
Mailing Address - Street 1:4870 BARRANCA PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4709
Mailing Address - Country:US
Mailing Address - Phone:949-552-1546
Mailing Address - Fax:949-552-2146
Practice Address - Street 1:4870 BARRANCA PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4709
Practice Address - Country:US
Practice Address - Phone:949-552-1546
Practice Address - Fax:949-552-2146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49971207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty