Active NPI
Nazar R Alsaffar, MD
- Diagnostic Radiology Physician
- Stockton, CA
National Provider Identifier
1922099332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- C42029
- Practice address
- 525 W Acacia St
Stockton, CA 95203-2405 - Phone
- (903) 465-1857
- Fax
- (903) 327-8023
- NPI assigned
- Nov 3, 2005
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | C42029 | CA | Primary |
Addresses
Primary practice location
525 W Acacia St
Stockton, CA 95203-2405
Mailing address
PO Box 548
Sherman, TX 75091-0548
Phone (903) 465-1857
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C420290 | 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 |
|---|---|---|---|
| 42029 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1922099332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 548",
"city": "SHERMAN",
"state": "TX",
"postal_code": "750910548",
"telephone_number": "903-465-1857",
"fax_number": "903-327-8023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 W ACACIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952032405",
"telephone_number": "903-465-1857",
"fax_number": "903-327-8023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALSAFFAR",
"first_name": "NAZAR",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "C42029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C420290",
"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 Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.