Provider Demographics
NPI:1174550396
Name:BAIG, MIRZA RAFIUDDIN (MD)
Entity type:Individual
Prefix:
First Name:MIRZA
Middle Name:RAFIUDDIN
Last Name:BAIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227
Mailing Address - Country:US
Mailing Address - Phone:760-344-5529
Mailing Address - Fax:760-344-0192
Practice Address - Street 1:565 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227
Practice Address - Country:US
Practice Address - Phone:760-344-5529
Practice Address - Fax:760-344-0192
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35515208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics