Provider Demographics
NPI:1629030895
Name:TUQAN, SA'D KHALIL (MD)
Entity type:Individual
Prefix:
First Name:SA'D
Middle Name:KHALIL
Last Name:TUQAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1901 TOWN AND COUNTRY DR
Mailing Address - Street 2:STE 104
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:951-808-6240
Mailing Address - Fax:951-738-9954
Practice Address - Street 1:2250 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5302
Practice Address - Country:US
Practice Address - Phone:951-734-4880
Practice Address - Fax:951-734-7963
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC37812207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C378120Medicaid
CA00C378120Medicaid