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General NPI Number Information
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NPI Number | 1659359404
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Entity Type | Individual
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Provider Name | AMAR SIDDIQUE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 916-703-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 TRUXEL RD APT # 127
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City | SACRAMENTO
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State | CA
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Zip | 95834-3708
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Country | US
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Telephone | 916-762-8200
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 125-047116
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License Number State | IL
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Taxonomy #2
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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 #3
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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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