Most Relevant Information
Provider Data
| NPI Number: | 1003487018 |
| Provider Name: | IMRAN AHMED SIDDIQI DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/09/2021 |
| Last Updated: | 07/09/2021 |
Provider Practice Location
26520 CACTUS AVE.
RUHS-MC ED BLDG RM. 339
MORENO VALLEY
CA
92555
Practice Location Phone/Fax
| Phone: | 9514865912 |
| Fax: | 9514865910 |
Provider Mailing Location
13162 58TH ST
EASTVALE
CA
928804601
Provider Mailing Phone/Fax
| Phone: | 8477146145 |
| Fax: |