Basic Information
| Provider Information | |||||||||
| NPI: | 1619276896 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIDHWA | ||||||||
| FirstName: | FEROZE | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 W FREMONT ST UNIT 702 | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952021915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438027789 | ||||||||
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| Practice Location | |||||||||
| Address1: | 725 ALBANY STREET | ||||||||
| Address2: | 3RD FLOOR, SUITE A | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021184776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144861 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2011 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 165468 | CA | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.