Healthcare Provider Details

I. General information

NPI: 1366514499
Provider Name (Legal Business Name): SHAHEEN IQBAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7851 WALKER ST STE 105
LA PALMA CA
90623-1734
US

IV. Provider business mailing address

609 W BEVERLY BLVD
MONTEBELLO CA
90640-3623
US

V. Phone/Fax

Practice location:
  • Phone: 714-266-0052
  • Fax: 714-670-2873
Mailing address:
  • Phone: 323-728-6445
  • Fax: 323-728-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA38557
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA38557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: