Active NPI
Fereydoun Azadi, M.D.
- Colon & Rectal Surgery Physician
- Modesto, CA
National Provider Identifier
1790714541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- A31338
- Practice address
- 1401 Spanos CT Ste 127
Modesto, CA 95355 - Phone
- (209) 525-3848
- Fax
- (209) 525-3886
- NPI assigned
- Jul 2, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A31338 | CA | |
| Surgical Critical Care Physician | 2086S0102X | A31338 | CA | |
| Trauma Surgery Physician | 2086S0127X | A31338 | CA | |
| Vascular Surgery Physician | 2086S0129X | A31338 | CA | |
| Colon & Rectal Surgery Physician | 208C00000X | A31338 | CA | Primary |
Addresses
Primary practice location
1401 Spanos CT Ste 127
Modesto, CA 95355
Mailing address
15 Lombard LN
Lafayette, CA 94549
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR076520 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31338 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1790714541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LOMBARD LN",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "94549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 SPANOS CT STE 127",
"city": "MODESTO",
"state": "CA",
"postal_code": "95355",
"telephone_number": "209-525-3848",
"fax_number": "209-525-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZADI",
"first_name": "FEREYDOUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A31338",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "CA",
"license": "A31338",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "CA",
"license": "A31338",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CA",
"license": "A31338",
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "CA",
"license": "A31338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR076520",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.