Healthcare Provider Details

I. General information

NPI: 1225606478
Provider Name (Legal Business Name): SUMIYAH SYED-UDDIN MSN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUMIYAH SYED

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 MEDICAL CENTER DR
MURRIETA CA
92562-5965
US

IV. Provider business mailing address

3020 CHILDRENS WAY # MC5003
SAN DIEGO CA
92123-4223
US

V. Phone/Fax

Practice location:
  • Phone: 951-696-6124
  • Fax:
Mailing address:
  • Phone: 858-309-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95019655
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number383234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: