Individual
DR. SHAHNAWAZ ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 883-8711
Mailing address
7102 STOCKYARD, RIVERSIDE, CA 92507-0188
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
PERMIT
NJ
Other
Enumeration date
08/24/2015
Last updated
02/12/2020
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