Provider Demographics
NPI:1124348479
Name:YAQUB, KASHIF (MD)
Entity type:Individual
Prefix:
First Name:KASHIF
Middle Name:
Last Name:YAQUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 VON KARMAN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2194
Mailing Address - Country:US
Mailing Address - Phone:949-678-8885
Mailing Address - Fax:949-335-9820
Practice Address - Street 1:4700 VON KARMAN AVE STE 101
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2194
Practice Address - Country:US
Practice Address - Phone:949-678-8885
Practice Address - Fax:949-335-9820
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125063207R00000X, 207RC0200X, 207RP1001X, 207R00000X
AZ48014207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine