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General NPI Number Information
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NPI Number | 1154474757
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Entity Type | Organization
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Legal Business Name | TEJASKUMAR NAIK MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 2083 COMPTON AVE SUITE 103
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City | CORONA
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State | CA
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Zip | 92881-7283
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Country | US
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Telephone | 951-372-0039
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Fax | 951-372-0180
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Provider Business Mailing Address
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Address Line | 2083 COMPTON AVE SUITE 103
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City | CORONA
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State | CA
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Zip | 92881-7283
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Country | US
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Telephone | 951-372-0039
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Fax | 951-372-0180
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Authorized Official
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Title or Position | PRESIDENT
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Name | TEJASKUMAR NAIK
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Credential | M.D.
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Telephone | 951-372-0039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C51412
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | C51412
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License Number State | CA
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