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General NPI Number Information
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NPI Number | 1538574660
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Entity Type | Organization
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Legal Business Name | AMAR SIDDIQUE MD INC
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 06/20/2021
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Provider Practice Location Address
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Address Line | 726 N MEDICAL CENTER DR E STE 205
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City | CLOVIS
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State | CA
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Zip | 93611-6886
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Country | US
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Telephone | 559-908-4852
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Fax | 559-354-5214
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Provider Business Mailing Address
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Address Line | 726 N MEDICAL CENTER DR E STE 205
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City | CLOVIS
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State | CA
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Zip | 93611-6886
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Country | US
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Telephone | 559-908-4852
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Fax | 559-354-5214
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMAR SIDDIQUE
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Credential | M.D
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Telephone | 559-908-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | A93835
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A93835
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License Number State | CA
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