Healthcare Provider Details

I. General information

NPI: 1770776577
Provider Name (Legal Business Name): SABINA HOQUE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 BRICKWAY BLVD VETERANS HEALTH SYSTEM
SANTA ROSA CA
95403-8226
US

IV. Provider business mailing address

3841 BRICKWAY BLVD VETERANS HEALTH SYSTEM
SANTA ROSA CA
95403-8226
US

V. Phone/Fax

Practice location:
  • Phone: 707-569-2340
  • Fax: 707-569-2383
Mailing address:
  • Phone: 707-569-2340
  • Fax: 707-569-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD434162
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: