Provider Demographics
NPI:1396048666
Name:NIAZI, SULTAN SALEEM (DO)
Entity type:Individual
Prefix:
First Name:SULTAN
Middle Name:SALEEM
Last Name:NIAZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COFFEE RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4201
Mailing Address - Country:US
Mailing Address - Phone:209-521-6097
Mailing Address - Fax:
Practice Address - Street 1:600 COFFEE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4201
Practice Address - Country:US
Practice Address - Phone:209-521-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.127901207R00000X
IN02006614A207R00000X
NH21625207R00000X
NJ25MB112887000207R00000X
OK7434207R00000X
PAOS022108207R00000X
RIDO01091207R00000X
TN4471207R00000X
CA20A12281208M00000X, 207R00000X
MO2022000980207R00000X
TXT5767207R00000X
ALDO.2595207R00000X
DEC2-0024020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine