Provider Demographics
NPI:1194744391
Name:DAWOOD, NAYYARA SULTANA (MD)
Entity type:Individual
Prefix:DR
First Name:NAYYARA
Middle Name:SULTANA
Last Name:DAWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:NAYYARA
Other - Middle Name:SULTANA
Other - Last Name:USMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:275 OCONNOR DR STE C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1657
Mailing Address - Country:US
Mailing Address - Phone:408-279-8786
Mailing Address - Fax:408-279-3941
Practice Address - Street 1:275 OCONNOR DR STE C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1657
Practice Address - Country:US
Practice Address - Phone:408-279-8786
Practice Address - Fax:408-279-3941
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63743208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A637430Medicaid
4550333Medicare UPIN