Organization
TAHIR YAQUB MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAHIR YAQUB MD (PROVIDER)
(209) 388-1371
Entity
Organization
Contact information
Practice address
1775 3RD STREET, OPTIONAL, ATWATER, CA 95301-3608
(209) 358-5611
(209) 358-0219
Mailing address
336 E BELLEVUE RD, MERCED, CA 95348-2727
(209) 489-0809
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A96088
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PP00376233
RAILROAD MEDICARE
CA
01
—
ZZZ77315Z
MEDI-CAL CALIFORNIA
CA
Enumeration date
07/27/2010
Last updated
07/15/2020
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