Healthcare Provider Details

I. General information

NPI: 1508316217
Provider Name (Legal Business Name): NAZEELA SABIR AWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAZEELA SABIR

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1996 DEL PASO RD STE 176
SACRAMENTO CA
95834-7731
US

IV. Provider business mailing address

1996 DEL PASO RD STE 176
SACRAMENTO CA
95834-7731
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number174576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: