Provider Demographics
NPI:1427476894
Name:QURESHI, SANA AHMAD
Entity type:Individual
Prefix:DR
First Name:SANA
Middle Name:AHMAD
Last Name:QURESHI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SANA
Other - Middle Name:
Other - Last Name:AHMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14122 PICASSO CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1824
Mailing Address - Country:US
Mailing Address - Phone:949-812-2785
Mailing Address - Fax:909-333-4941
Practice Address - Street 1:1910 ROYALTY DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3021
Practice Address - Country:US
Practice Address - Phone:909-333-4941
Practice Address - Fax:909-333-4941
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA171247208C00000X, 208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program