Healthcare Provider Details

I. General information

NPI: 1538134762
Provider Name (Legal Business Name): AIJAZ HASHMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E TACHEVAH DR BLDG 1E STE 105
PALM SPRINGS CA
92262-5750
US

IV. Provider business mailing address

555 E TACHEVAH DR BLDG 1E STE 105
PALM SPRINGS CA
92262-5750
US

V. Phone/Fax

Practice location:
  • Phone: 760-318-8100
  • Fax: 760-318-8102
Mailing address:
  • Phone: 760-318-8100
  • Fax: 760-318-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA66814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: