Provider Demographics
NPI:1558372508
Name:NIAZI, LAILA (MD)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:NIAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-924-9337
Mailing Address - Fax:916-924-8281
Practice Address - Street 1:650 HOWE AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-924-9337
Practice Address - Fax:916-924-8281
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91451208000000X
CAA914510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics