Active NPI
Azad Raiesdana, MD
- Cardiovascular Disease Physician
- Stanford, CA
National Provider Identifier
1497094171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- A64006
- Practice address
- 300 Pasteur Drive
Stanford, CA 94305 - Phone
- (650) 518-9773
- NPI assigned
- Jan 31, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | A64006 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Drive
Stanford, CA 94305
Mailing address
277 Charles Marx Way
Palo Alto, CA 94304
Phone (650) 518-9773
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 |
|---|---|---|---|
| A64006 | CA | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397520000000",
"number": "1497094171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "277 CHARLES MARX WAY",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94304",
"telephone_number": "650-518-9773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DRIVE",
"city": "STANFORD",
"state": "CA",
"postal_code": "94305",
"telephone_number": "650-518-9773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIESDANA",
"first_name": "AZAD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-31",
"last_updated": "2014-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "A64006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.