| Hajera Sultana Md., Inc | |
|
3838 Sherman Dr Ste 12 Riverside CA 92503-4001 | |
| (951) 351-9994 | |
| (951) 351-2394 |
| Full Name | Hajera Sultana Md., Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3838 Sherman Dr, Riverside, California |
| Authorized Official Name and Position | Hajera Sultana (PRESIDENT) |
| Authorized Official Contact | 9512834725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hajera Sultana Md., Inc 3838 Sherman Dr Ste 12 Riverside CA 92503-4001 Ph: (951) 351-9994 | Hajera Sultana Md., Inc 3838 Sherman Dr Ste 12 Riverside CA 92503-4001 Ph: (951) 351-9994 |
| NPI Number | 1821278169 |
|---|---|
| Provider Enumeration Date | 11/04/2007 |
| Last Update Date | 11/04/2007 |
| Medicare PECOS PAC ID | 0749225142 |
|---|---|
| Medicare Enrollment ID | O20050627000459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821278169 | NPI | - | NPPES |
| 1063537306 | Other | CA | INDIVIDUAL NPI NUMBER |
| OOA785890 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A78589 (California) | Primary |
| Provider Name | Hajera Sultana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063537306 PECOS PAC ID: 9436195658 Enrollment ID: I20050629001155 |
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