Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 036.153084 | IL |
Y | 207RA0201X | Internist - Allergy & Immunology | A153858 | CA |
NPI | 1619363314 |
---|---|
Provider Name | Aminaa Siddiqi |
First Address | Warrenville, IL 60555-1280 |
Second Address | Davis, CA 95616-5671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2015 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FS7596818 | DEA (01) | CA |