Basic Information
| Provider Information | |||||||||
| NPI: | 1790196756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIJJAR | ||||||||
| FirstName: | SONNY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 317 S CLINTON ST APT 4B | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132021283 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 HAWTHORNE AVE RM 2346 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108696883 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2014 | ||||||||
| LastUpdateDate: | 10/26/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A146388 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A146388 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.