Healthcare Provider Details

I. General information

NPI: 1528139722
Provider Name (Legal Business Name): BABAR IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BABAR IQBAL MD

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 RIVERWALK PKWY SUITE 120
RIVERSIDE CA
92505-3368
US

IV. Provider business mailing address

PO BOX 8458
RIVERSIDE CA
92515-8458
US

V. Phone/Fax

Practice location:
  • Phone: 951-729-9822
  • Fax:
Mailing address:
  • Phone: 951-729-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number39224
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: