Healthcare Provider Details

I. General information

NPI: 1194744391
Provider Name (Legal Business Name): NAYYARA SULTANA DAWOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NAYYARA SULTANA USMANI MD

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 OCONNOR DR STE C
SAN JOSE CA
95128-1657
US

IV. Provider business mailing address

275 OCONNOR DR STE C
SAN JOSE CA
95128-1657
US

V. Phone/Fax

Practice location:
  • Phone: 408-279-8786
  • Fax: 408-279-3941
Mailing address:
  • Phone: 408-279-8786
  • Fax: 408-279-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA63743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: