Individual
BUSHRA JAWAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 COTTAGE AVE STE 103, MANTECA, CA 95336-4935
(209) 624-5800
Mailing address
3661 COUNTRY CLUB TER, DANVILLE, CA 94506-6064
(650) 787-4617
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
A107456
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/02/2009
Last updated
01/29/2013
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