MEDICARE: ABDULHAFEEZ BIN MOHAMADSHAFIQ

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	342000000X	Transportation Network Company		AZ

General Provider Information

NPI Number	:	1780531574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDULHAFEEZ BIN MOHAMADSHAFIQ

Provider Business Mailing Address
First Line	:	8622 N 59TH AVE APT 2141
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-4593
Country	:	US
Telephone Number	:	619-727-3399
Fax Number	:

Provider Business Practice Location Address
First Line	:	8622 N 59TH AVE APT 2141
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-4593
Country	:	US
Telephone Number	:	619-727-3399
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ ABDULHAFEEZ BIN MOHAMADSHAFIQ ” Practice Location

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