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General NPI Number Information
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NPI Number | 1386453355
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Entity Type | Organization
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Legal Business Name | HATEEM SIDDIQUI MD PC
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Dates
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Enumeration Date | 01/04/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1800 WESTERN AVE STE 409
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1355
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Country | US
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Telephone | 909-202-4336
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Fax | 909-222-6023
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Provider Business Mailing Address
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Address Line | PO BOX 91
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91729-0091
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Country | US
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Telephone | 818-770-9073
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HATEEM SIDDIQUI
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Credential | MD
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Telephone | 818-770-9073
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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 |
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License Number State |
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