Provider Demographics
NPI:1982752465
Name:FAROOQUI, MOHAMMED SHARJEEL (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:SHARJEEL
Last Name:FAROOQUI
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 1:18433 ROSCOE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4134
Mailing Address - Country:US
Mailing Address - Phone:818-349-1262
Mailing Address - Fax:844-350-5438
Practice Address - Street 1:18433 ROSCOE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4134
Practice Address - Country:US
Practice Address - Phone:818-349-1262
Practice Address - Fax:844-350-5438
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97911208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A979110Medicaid
CAHK309ZMedicare PIN
CA00A979110Medicaid
CAI70240Medicare UPIN