Basic Information
| Provider Information | |||||||||
| NPI: | 1902094782 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADEELA N. ANSARI M.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7600 HOSPITAL DR | ||||||||
| Address2: | SUITE C | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958235406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2098451346 | ||||||||
| FaxNumber: | 2098451364 | ||||||||
| Practice Location | |||||||||
| Address1: | 7600 HOSPITAL DR | ||||||||
| Address2: | SUITE C | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958235406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2098451346 | ||||||||
| FaxNumber: | 2098451364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2007 | ||||||||
| LastUpdateDate: | 10/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | ANSARI | ||||||||
| AuthorizedOfficialFirstName: | ADEELA | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2098451346 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | A84699 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.