Healthcare Provider Details

I. General information

NPI: 1376283747
Provider Name (Legal Business Name): HAMZA SIDDIQI HANSOTI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MEDICAL PLAZA DR STE 200
ROSEVILLE CA
95661-3114
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 916-773-8711
  • Fax: 916-732-0420
Mailing address:
  • Phone: 800-470-0071
  • Fax: 916-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number24501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: