=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952868002
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AALIYA H YAQUB MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2019
-----------------------------------------------------
Last Update Date | 02/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 BUSH ST STE 1600
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94104-3918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-597-8432
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 BUSH ST STE 1600
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94104-3918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-597-8432
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. AALIYA YAQUB
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 909-935-7986
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------