Provider Demographics
NPI:1528480753
Name:IQBAL SURGICAL ASSOCIATES,INC.
Entity type:Organization
Organization Name:IQBAL SURGICAL ASSOCIATES,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ATIF
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-599-8222
Mailing Address - Street 1:18225 BROOKHURST ST STE 5
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6719
Mailing Address - Country:US
Mailing Address - Phone:714-599-8222
Mailing Address - Fax:714-599-8223
Practice Address - Street 1:18225 BROOKHURST ST STE 5
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6719
Practice Address - Country:US
Practice Address - Phone:714-599-8222
Practice Address - Fax:714-599-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA104130Medicaid