Provider Demographics
NPI:1285939991
Name:MUSTAFA, FAIZE PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:FAIZE
Middle Name:PATRICIA
Last Name:MUSTAFA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:FAIZE
Other - Middle Name:PATRICIA
Other - Last Name:MUSTAFA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7117 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2658
Mailing Address - Country:US
Mailing Address - Phone:951-782-3638
Mailing Address - Fax:951-784-3257
Practice Address - Street 1:7117 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2658
Practice Address - Country:US
Practice Address - Phone:951-782-3638
Practice Address - Fax:951-784-3257
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112589208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics