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General NPI Number Information
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NPI Number | 1326289737
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Entity Type | Organization
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Legal Business Name | SADEEQ KHAN SADIQ, INC.
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 888 PALM AVE
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-1529
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Country | US
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Telephone | 619-423-0100
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Fax | 619-423-0120
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Provider Business Mailing Address
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Address Line | 888 PALM AVE
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-1529
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Country | US
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Telephone | 619-423-0100
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Fax | 619-423-0120
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SADEEQ KHAN SADIQ
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Credential | M.D.
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Telephone | 619-423-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A89200
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License Number State | CA
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