Active NPI
Diamond Kassam, M.D.
- Pediatric Adolescent Medicine Physician
- Sacramento, CA
National Provider Identifier
1417036187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- A31963
- Practice address
- 9601 Kiefer Blvd
Sacramento, CA 95827-3818 - Phone
- (916) 875-5015
- Fax
- (916) 875-5734
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | A31963 | CA | Primary |
Addresses
Primary practice location
9601 Kiefer Blvd
Sacramento, CA 95827-3818
Mailing address
1151 Euclid Ave
Berkeley, CA 94708-1602
Phone (510) 913-9501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A31963 | CA | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417036187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 EUCLID AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947081602",
"telephone_number": "510-913-9501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 KIEFER BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958273818",
"telephone_number": "916-875-5015",
"fax_number": "916-875-5734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSAM",
"first_name": "DIAMOND",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CA",
"license": "A31963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.