SHAFI SIDDIQI MD A PROFESSIONAL CORPORATION
NPI 1477229995
General Practice in Lake Elsinore, CA

Q: What is Shafi Siddiqi MD A Professional Corporation's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since August 17, 2021CLIA 05D2311012 · Waiver

31569 CANYON ESTATES DR STE 201, LAKE ELSINORE, CA 92532(951) 226-0866(951) 226-0868 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shafi Siddiqi Md A Professional Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAFI SIDDIQI MD A PROFESSIONAL CORPORATION (NPI 1477229995) is a healthcare organization registered as a general practice in Lake Elsinore, California and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through September 15, 2026 and lists Brigette Jackson, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1477229995

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameSHAFI SIDDIQI MD A PROFESSIONAL CORPORATION

Location Address31569 CANYON ESTATES DR STE 201Lake Elsinore, CA 92532-0475

Mailing Address31569 Canyon Estates Dr Ste 201Lake Elsinore, CA 92532-0475 · (951) 226-0866 · Fax (951) 226-0868

Phone(951) 226-0866

Fax(951) 226-0868

Organization SubpartNo

Authorized OfficialBrigette JacksonCredentialing Specialist · (951) 667-0817

Enumeration DateAugust 17, 2021

NPPES CertifiedAugust 17, 2021

✔ NPI 1477229995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

31569 CANYON ESTATES DR STE 201, Lake Elsinore, CA 92532

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2311012

Shafi Siddiqi MD · Lake Elsinore, CA

Active · expires Sep 15, 2026

CLIA Number05D2311012

Laboratory TypePhysician Office

Certificate Effective DateSeptember 16, 2024

Certificate Expiration DateSeptember 15, 2026

Laboratory DirectorShafi U. Siddiqi

Laboratory Phone(951) 226-0866

Laboratory LocationShafi Siddiqi MD31569 Canyon Estates Dr Suite 201, Lake Elsinore, CA 92532

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shafi Siddiqi MD A Professional Corporation's NPI number?

The NPI number for Shafi Siddiqi MD A Professional Corporation is 1477229995. It was assigned to this organization in the NPPES registry on August 17, 2021.

Where is Shafi Siddiqi MD A Professional Corporation located?

Shafi Siddiqi MD A Professional Corporation is located at 31569 Canyon Estates Dr Ste 201, Lake Elsinore, CA 92532. The listed phone number is (951) 226-0866.

What is Shafi Siddiqi MD A Professional Corporation's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Shafi Siddiqi MD A Professional Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2311012) is associated with this NPI, valid through September 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Shafi Siddiqi MD A Professional Corporation was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.