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NPI Code Detail

MEDICARE: SADEEQ KHAN SADIQ, INC.

MEDICARE: SADEEQ KHAN SADIQ, INC.
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
1261QU0200XUrgent Care Clinic/CenterA89200CA

General Provider Information

NPI Number : 1326289737
Entity Type Code : Organization
Provider Name (Legal Business Name) : SADEEQ KHAN SADIQ, INC.
Provider Business Mailing Address
First Line : 888 PALM AVE
Second Line :
City : IMPERIAL BEACH
State : CA
Zip : 91932-1529
Country : US
Telephone Number : 619-423-0100
Fax Number : 619-423-0120
Provider Business Practice Location Address
First Line : 888 PALM AVE
Second Line :
City : IMPERIAL BEACH
State : CA
Zip : 91932-1529
Country : US
Telephone Number : 619-423-0100
Fax Number : 619-423-0120
Authorized Official
Title or Position : DIRECTOR
Name : DR. SADEEQ KHAN SADIQ
Credential : M.D.
Telephone Number : 619-423-0100
Provider Enumeration Date : 03/13/2009
Last Update Date : 02/02/2015

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