MEDICARE: ATP PARTNERS OF CALIFORNIA, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084V0102X	Vascular Neurology Physician

General Provider Information

NPI Number	:	1093497745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATP PARTNERS OF CALIFORNIA, P.C.

Provider Business Mailing Address
First Line	:	10175 FORTUNE PKWY UNIT 302
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6749
Country	:	US
Telephone Number	:	904-610-3393
Fax Number	:	904-687-1413

Provider Business Practice Location Address
First Line	:	1325 J ST STE 1550
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-2976
Country	:	US
Telephone Number	:	904-610-3393
Fax Number	:	904-687-1413

Authorized Official
Title or Position	:	MD
Name	:	MUHAMMAD FAROOQ
Credential	:
Telephone Number	:	904-610-3393

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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