Healthcare Provider Details

I. General information

NPI: 1235542531
Provider Name (Legal Business Name): SANNA FATIMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4053 LONE TREE WAY STE 201
ANTIOCH CA
94531-6210
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 925-513-2483
  • Fax: 925-513-8226
Mailing address:
  • Phone: 925-756-3400
  • Fax: 510-506-7728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA154332
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD461484
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: