Organization
SOUTHERN CALIFORNIA GASTROENTEROLOY & HEPATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAHMINA SULTANA HAQ M.D. (O5167616WNER)
(310) 487-7468
Entity
Organization
Contact information
Practice address
910 S SUNSET AVE, SUITE 5, WEST COVINA, CA 91790-3409
(310) 487-7468
Mailing address
910 S SUNSET AVE, SUITE 5, WEST COVINA, CA 91790-3409
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
A116126
CA
261QA1903X
Ambulatory Surgical Clinic/Center
A116126
CA
261QE0800X
Endoscopy Clinic/Center
A116126
CA
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
282E00000X
Long Term Care Hospital
A116126
CA
282N00000X
General Acute Care Hospital
A116126
CA
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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