Provider Demographics
NPI:1134190374
Name:SIDDIQI, NAEEM A (MD)
Entity type:Individual
Prefix:
First Name:NAEEM
Middle Name:A
Last Name:SIDDIQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 EMILY WAY
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5647
Mailing Address - Country:US
Mailing Address - Phone:559-674-2300
Mailing Address - Fax:559-674-1551
Practice Address - Street 1:924 EMILY WAY
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5647
Practice Address - Country:US
Practice Address - Phone:559-674-2300
Practice Address - Fax:559-674-1551
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51941207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C519410Medicaid
CA00C519410Medicare ID - Type Unspecified
CA00C519410Medicaid