Provider Demographics
NPI:1205071222
Name:ULLAH, NUSHRAT (MD)
Entity type:Individual
Prefix:DR
First Name:NUSHRAT
Middle Name:
Last Name:ULLAH
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 1:2350 W EL CAMINO REAL FL 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-6203
Mailing Address - Country:US
Mailing Address - Phone:415-878-7200
Mailing Address - Fax:415-369-7916
Practice Address - Street 1:101 ROWLAND WAY STE 220
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5056
Practice Address - Country:US
Practice Address - Phone:415-878-7200
Practice Address - Fax:415-369-7916
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252800207R00000X
CAA120589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine