Provider Demographics
NPI:1861782674
Name:IQBAL, AFZAAL
Entity type:Individual
Prefix:
First Name:AFZAAL
Middle Name:
Last Name:IQBAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16787 BEACH BLVD
Mailing Address - Street 2:BOX 276
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4848
Mailing Address - Country:US
Mailing Address - Phone:714-963-7240
Mailing Address - Fax:714-963-7224
Practice Address - Street 1:18111 BROOKHURST ST
Practice Address - Street 2:STE 3100
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6728
Practice Address - Country:US
Practice Address - Phone:714-963-7240
Practice Address - Fax:714-963-7224
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143130207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine