Individual provider Active NPI

Naju M Dah, MD

  • Adult Medicine Physician
  • Stockton, CA
National Provider Identifier
1609920727
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A31448 Issued in CA
Practice address
2800 N California St
Suite #17
Stockton, CA 95204-3757
Phone
(209) 466-5888
Fax
(209) 466-1589
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A31448 CA Primary

Addresses

Primary practice location

2800 N California St
Suite #17
Stockton, CA 95204-3757

Mailing address

2800 N California St
Suite #17
Stockton, CA 95204-3757
Phone (209) 466-5888

Other identifiers 1

IdentifierTypeStateIssuer
00A314480MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31448CAMDGeneral Practice Dentistry
A31448CAMDAdult Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609920727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST",
            "address_2": "SUITE #17",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043757",
            "telephone_number": "209-466-5888",
            "fax_number": "209-466-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST",
            "address_2": "SUITE #17",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043757",
            "telephone_number": "209-466-5888",
            "fax_number": "209-466-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAH",
        "first_name": "NAJU",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A31448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A314480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, 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.

Verify at the official NPI Registry.