Healthcare Provider Details

I. General information

NPI: 1932514544
Provider Name (Legal Business Name): SEEMA NAYAK MD CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 W STANDLEY ST
UKIAH CA
95482-4347
US

IV. Provider business mailing address

413 W STANDLEY ST
UKIAH CA
95482-4347
US

V. Phone/Fax

Practice location:
  • Phone: 707-462-3300
  • Fax: 707-462-3303
Mailing address:
  • Phone: 707-462-3300
  • Fax: 707-462-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SEEMA NAYAK
Title or Position: CEO/DIRECTOR
Credential: MD
Phone: 646-256-0894