Basic Information
| Provider Information | |||||||||
| NPI: | 1720184898 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAROOQ | ||||||||
| FirstName: | MUHAMMAD | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MPH, MBA, FAAFP | ||||||||
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| Mailing Information | |||||||||
| Address1: | P O BOX 1841 | ||||||||
| Address2: | |||||||||
| City: | NORCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928600991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517372683 | ||||||||
| FaxNumber: | 9512732318 | ||||||||
| Practice Location | |||||||||
| Address1: | 3777 COOLHEIGHTS DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO PALOS VERDES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902756234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103777736 | ||||||||
| FaxNumber: | 3104277730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | H36374 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.