Healthcare Provider Details

I. General information

NPI: 1417028630
Provider Name (Legal Business Name): AFSHAN NURI BAIG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MAIN ST
BRAWLEY CA
92227-2630
US

IV. Provider business mailing address

1166 K ST
BRAWLEY CA
92227-2737
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-6471
  • Fax: 760-344-8410
Mailing address:
  • Phone: 760-344-6471
  • Fax: 760-344-8410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA49428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: