Healthcare Provider Details

I. General information

NPI: 1982908208
Provider Name (Legal Business Name): SAYEEDA SULTANA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1788 SIERRA LEONE AVE SUITE 105
ROWLAND HEIGHTS CA
91748-5886
US

IV. Provider business mailing address

1788 SIERRA LEONE AVE SUITE 105
ROWLAND HEIGHTS CA
91748-5886
US

V. Phone/Fax

Practice location:
  • Phone: 909-568-4507
  • Fax: 562-222-2225
Mailing address:
  • Phone: 909-568-4507
  • Fax: 562-222-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA53436
License Number StateCA

VIII. Authorized Official

Name: SAYEEDA SULTANA
Title or Position: DIRECTOR
Credential: MD
Phone: 909-568-4507