Basic Information
| Provider Information | |||||||||
| NPI: | 1710183066 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEG | ||||||||
| FirstName: | HUMAYUN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13033 SIGNATURE PT | ||||||||
| Address2: | APT 180 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921301529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148257371 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 852 DANENBERG DR | ||||||||
| Address2: | |||||||||
| City: | EL CENTRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922438517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603522257 | ||||||||
| FaxNumber: | 7603524579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2007 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 0101273598 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | A87107 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 85-2534724 | 01 | CA | ALL COMMERCIAL | OTHER | A87107 | 05 | CA | MEDICAID |