Individual
SHOAB SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 Q ST, SACRAMENTO, CA 95816-7058
(916) 733-3333
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
A71415
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810579445
PHCS
CA
05
—
00A714150
—
CA
01
—
079115
HEALTH NET
CA
01
—
1294175
GREAT WEST
CA
01
—
1837078
FIRST HEALTH
CA
01
—
1968751
UNITED HEALTHCARE
CA
01
—
44530
INTERPLAN
CA
01
—
7494423
CIGNA
CA
01
—
7796146
AETNA
CA
01
—
90138939
PACIFICARE
CA
01
—
A71415
BLUE CROSS
CA
01
—
MCMG298400
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
08/31/2006
Last updated
02/13/2012
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