Provider Demographics
NPI:1982908208
Name:SAYEEDA SULTANA MD INC
Entity Type:Organization
Organization Name:SAYEEDA SULTANA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAYEEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-568-4507
Mailing Address - Street 1:1788 SIERRA LEONE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-5886
Mailing Address - Country:US
Mailing Address - Phone:909-568-4507
Mailing Address - Fax:562-222-2225
Practice Address - Street 1:1788 SIERRA LEONE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-5886
Practice Address - Country:US
Practice Address - Phone:909-568-4507
Practice Address - Fax:562-222-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53436208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1497841258Medicaid