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General NPI Number Information
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NPI Number | 1063537306
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Entity Type | Individual
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Provider Name | HAJERA SULTANA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 3838 SHERMAN DR STE 12
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City | RIVERSIDE
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State | CA
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Zip | 92503-4001
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Country | US
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Telephone | 951-351-9994
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Fax | 951-351-2394
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Provider Business Mailing Address
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Address Line | PO BOX 78945
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City | CORONA
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State | CA
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Zip | 92877-0164
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Country | US
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Telephone |
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Fax | 951-351-2394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A78589
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License Number State | CA
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