Basic Information
| Provider Information | |||||||||
| NPI: | 1437453438 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURESHI | ||||||||
| FirstName: | SHEHZAANA | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5395 RUFFIN ROAD. | ||||||||
| Address2: | STE. 204 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585713630 | ||||||||
| FaxNumber: | 8585713649 | ||||||||
| Practice Location | |||||||||
| Address1: | 5395 RUFFIAN ROAD. | ||||||||
| Address2: | ST. 204 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585713630 | ||||||||
| FaxNumber: | 8585713640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2011 | ||||||||
| LastUpdateDate: | 05/31/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA21286 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.