Provider Demographics
NPI:1891671392
Name:DEEN ENTERPRISES MEDICAL CORPORATION
Entity type:Organization
Organization Name:DEEN ENTERPRISES MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOHAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-353-3222
Mailing Address - Street 1:435 W ATEN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9819
Mailing Address - Country:US
Mailing Address - Phone:760-344-7976
Mailing Address - Fax:
Practice Address - Street 1:435 W ATEN RD STE 2
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9819
Practice Address - Country:US
Practice Address - Phone:760-344-7976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEEN ENTERPRISES MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty