Healthcare Provider Details

I. General information

NPI: 1265470173
Provider Name (Legal Business Name): NAUREEN A. SHAIKH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SECOND STREET
SAUSALITO CA
94965
US

IV. Provider business mailing address

111 SECOND STREET
SAUSALITO CA
94965
US

V. Phone/Fax

Practice location:
  • Phone: 415-332-2600
  • Fax: 415-332-2610
Mailing address:
  • Phone: 415-332-2600
  • Fax: 415-332-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA81442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: