Healthcare Provider Details

I. General information

NPI: 1295839934
Provider Name (Legal Business Name): MAJID SHAHBAZ MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 RESERVOIR DR # 312
SAN DIEGO CA
92120-5134
US

IV. Provider business mailing address

5555 RESERVOIR DRIVE SUITE 312
SAN DIEGO CA
92120
US

V. Phone/Fax

Practice location:
  • Phone: 619-583-1174
  • Fax: 619-583-4609
Mailing address:
  • Phone: 619-583-1174
  • Fax: 619-583-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAJID SHAHBAZ
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 619-583-1174