Healthcare Provider Details

I. General information

NPI: 1902722648
Provider Name (Legal Business Name): SAQIB RAZZAQUE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 S IMPERIAL AVE
EL CENTRO CA
92243-4241
US

IV. Provider business mailing address

605 W H ST STE 110
BRAWLEY CA
92227-2250
US

V. Phone/Fax

Practice location:
  • Phone: 619-755-9204
  • Fax:
Mailing address:
  • Phone: 619-755-9204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAQIB RAZZAQUE
Title or Position: CEO
Credential: MD
Phone: 347-416-3434