Shanti Siddiqui, M.D. a Professional Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

C-51834 Issued in CA

Legal business name

SHANTI SIDDIQUI, M.D. A PROFESSIONAL CORPORATION

Practice address

609 New York Ranch Rd
Jackson, CA 95642-9328

Phone

(209) 257-0311

Fax

(209) 257-0302

NPI assigned

Mar 18, 2008

Last updated

Mar 18, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shanti Siddiqui, M.D.NPI 1679657860

Title

Owner

Phone

(209) 257-0311

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shanti Siddiqui, M.D.

  • Gastroenterology Physician
  • Jackson, CA
  • NPI 1679657860
  Authorized official Same address or phone
• Mohammed Nasiruddin Siddiqui, MD FACS

  • Surgery Physician
  • Jackson, CA
  • NPI 1366513426
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1407027444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0311",
            "fax_number": "209-257-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0311",
            "fax_number": "209-257-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTI SIDDIQUI, M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SHANTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-257-0311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C-51834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Felice Sapienza-Boundy, LCSW
• Kelly Sea, RD
• Amanda Seaman, L.AC.
• Ekaterina D Seeba, FNP
• Natalie Diane Serrano, RN
• Kathryn Sharp, MS, PPS
• Julia Ann Shelby, NP
• Gary G Shi, MD, PHD
• Jennifer Monique Shoemaker, MD
• Anisa Shoghi Ghaleh Shahi, PHARMD

• Specialist in Jackson, CA
• Providers in Jackson, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.