Provider Demographics
NPI:1205096831
Name:SADIQ, HUMAIRA (MD)
Entity type:Individual
Prefix:
First Name:HUMAIRA
Middle Name:
Last Name:SADIQ
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 1:6331 N FRESNO ST STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5283
Mailing Address - Country:US
Mailing Address - Phone:559-437-2700
Mailing Address - Fax:559-437-2712
Practice Address - Street 1:6331 N. FRESNO ST.
Practice Address - Street 2:#104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-437-2700
Practice Address - Fax:559-437-2712
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAY039ZMedicare PIN