Healthcare Provider Details

I. General information

NPI: 1134024250
Provider Name (Legal Business Name): NOAH SULTAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 MARINA VILLAGE PKWY
ALAMEDA CA
94501-6427
US

IV. Provider business mailing address

5103 WEST ST APT C
OAKLAND CA
94608-3247
US

V. Phone/Fax

Practice location:
  • Phone: 510-337-7950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: