Healthcare Provider Details
I. General information
NPI: 1497841258
Provider Name (Legal Business Name): SAYEEDA SULTANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8854 WHITTIER BLVD
PICO RIVERA CA
90660-2658
US
IV. Provider business mailing address
8854 WHITTIER BLVD
PICO RIVERA CA
90660-2658
US
V. Phone/Fax
- Phone: 562-942-9895
- Fax: 562-222-2225
- Phone: 562-942-9895
- Fax: 562-222-2225
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A53436 |
| License Number State | CA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | A53436 |
| Identifier Type | OTHER |
| Identifier State | CA |
| Identifier Issuer | MEDICAL LICENSE |
| # 2 | |
| Identifier | 00A534360 |
| Identifier Type | MEDICAID |
| Identifier State | CA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: