Alfred a Sidhom M D Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A35526 Issued in CA

Legal business name

ALFRED A SIDHOM M D INC

Doing business as

Advanced Urology Medical Center

Practice address

1211 W la Palma Ave
502
Anaheim, CA 92801-2815

Phone

(714) 776-7090

Fax

(714) 776-5632

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alfred A Sidhom, MDNPI 1114923265

Title

Doctor

Phone

(714) 776-7090

Specialties & licenses 1

Addresses

Other names 1

• Advanced Urology Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alfred A Sidhom, M.D.

  • Urology Physician
  • Anaheim, CA
  • NPI 1114923265
  Medicare reassignment Care Compare group Authorized official
• Mohammad H. Faysal, MD

  • Urology Physician
  • Anaheim, CA
  • NPI 1942371984
  Medicare reassignment Care Compare group
• Manmohan Gursahani, MD

  • Urology Physician
  • Fullerton, CA
  • NPI 1720042336
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1154441343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "502",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-776-7090",
            "fax_number": "714-776-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "502",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-776-7090",
            "fax_number": "714-776-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED A SIDHOM M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "SIDHOM",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "714-776-7090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A35526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Urology Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Urology Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Alexander, PPSP
• Monica Henrik Alexanians
• Genesis Alfaro, MA
• Sydney Alferos
• Denise Alfonso
• Ziyad Said Alguraan, SA-C
• Mariam Alhakim, CPNP-PC
• Lena Alhassan
• Ali a Ali MD Inc
• Ali R Tajik MD Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.