Sadick J Alsadir, MD

Individual provider Active NPI Internal Medicine Physician · Menlo Park, CA

NPI 1861563017 · NPPES record last updated Sep 17, 2007

Key facts

NPI
1861563017
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
A60696 (CA)
Practice address
795 Willow Rd BLDG 334
Menlo Park, CA 94025-2539
Phone
(650) 599-3890
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A60696CAMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A60696 CA Yes

Addresses

Primary practice location

795 Willow Rd BLDG 334
Menlo Park, CA 94025-2539

Mailing address

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Other identifiers

IdentifierTypeStateIssuer
00A606960MedicaidCA

Other providers in Menlo Park, CA

All providers in Menlo Park, CA · Internal Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.