Basic Information
| Provider Information | |||||||||
| NPI: | 1063593739 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BASIM Z. ABDELKARIM, M.D., INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BASIM Z. ABDELKARIM M.D. | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 SAN BERNARDINO RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917864985 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099200444 | ||||||||
| FaxNumber: | 9099205044 | ||||||||
| Practice Location | |||||||||
| Address1: | 1310 SAN BERNARDINO RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917864985 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099200444 | ||||||||
| FaxNumber: | 9099205044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 04/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | ABDELKARIM | ||||||||
| AuthorizedOfficialFirstName: | BASIM | ||||||||
| AuthorizedOfficialMiddleName: | Z | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9099200444 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | A74259 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.