IMHOTEP MUSTAQEEM NPI 1104220912

NPI Information

NPI: 1104220912
Provider Name: IMHOTEP MUSTAQEEM
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3336 STEEL STREET
SAN DIEGO, CA
ZIP 92113
Phone: (619) 822-7919
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Imhotep Mustaqeem is an addiction (substance use disorder) counselor in San Diego, CA. Imhotep Mustaqeem NPI is 1104220912. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3336 STEEL STREET
SAN DIEGO, CA
ZIP 92113
Phone: (619) 822-7919

The enumeration date for this NPI number is 10/22/2014 and was last updated on 10/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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