MEDICARE: DR. SHAHEEN IQBAL M.D.

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	174400000X	Specialist	A38557	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A38557	OTHER	CA	MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00A385570	OTHER	CA	MEDI-CAL PROVIDER NUMBER

General Provider Information

NPI Number	:	1366514499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHEEN IQBAL M.D.

Provider Business Mailing Address
First Line	:	609 W BEVERLY BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-3623
Country	:	US
Telephone Number	:	323-728-6445
Fax Number	:	323-728-9804

Provider Business Practice Location Address
First Line	:	609 W BEVERLY BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-3623
Country	:	US
Telephone Number	:	323-728-6445
Fax Number	:	323-728-9804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/23/2010

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Directions to “ DR. SHAHEEN IQBAL M.D.” Practice Location

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