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General NPI Number Information
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NPI Number | 1285933416
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Entity Type | Individual
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Provider Name | ADAM SIDDIQUI R.EPT, CNIM
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Gender | Male
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 2655 1ST ST STE 250
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City | SIMI VALLEY
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State | CA
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Zip | 93065-1574
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Country | US
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Telephone | 214-972-8151
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Fax | 877-705-3046
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Provider Business Mailing Address
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Address Line | 2781 ITHACA PLACE
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City | LEWISVILLE
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State | TX
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Zip | 75067
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Country | US
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Telephone | 214-972-8151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | REPT1104
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | CNIM2124
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License Number State |
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Taxonomy #3
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | 2124
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License Number State | CA
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