Provider Demographics
NPI:1568447357
Name:QURESHI, HUMA SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMA
Middle Name:SARAH
Last Name:QURESHI
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 1:1902 ROYALTY DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3030
Mailing Address - Country:US
Mailing Address - Phone:909-620-8180
Mailing Address - Fax:909-469-6741
Practice Address - Street 1:1902 ROYALTY DR
Practice Address - Street 2:SUITE 220
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3030
Practice Address - Country:US
Practice Address - Phone:909-620-8180
Practice Address - Fax:909-469-6741
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1048162085R0202X
CAA554062085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACG1263OtherRAILROAD MEDICARE
CA00A554060Medicaid
CACG1263OtherRAILROAD MEDICARE
CA00A554060Medicare PIN
CAG94929Medicare UPIN