Healthcare Provider Details

I. General information

NPI: 1033261250
Provider Name (Legal Business Name): NAZIR J. HABIB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WOODLAND RD
SAINT HELENA CA
94574-9554
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-6399
  • Fax: 707-967-5915
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA37866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: