Basic Information
| Provider Information | |||||||||
| NPI: | 1124348479 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAQUB | ||||||||
| FirstName: | KASHIF | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PACIFIC PULMONARY MEDICAL GROUP | ||||||||
| Address2: | 4234 RIVERWALK PARKWAY SUITE 230 | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517813672 | ||||||||
| FaxNumber: | 9517810365 | ||||||||
| Practice Location | |||||||||
| Address1: | PACIFIC PULMONARY MEDICAL GROUP | ||||||||
| Address2: | 4234 RIVERWALK PARKWAY SUITE 230 | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517813672 | ||||||||
| FaxNumber: | 9517810365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2010 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | A125063 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | A125063 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207R00000X | R72105 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 48014 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | A125063 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.