NPIMap

Organization Active NPI

Mussa Banisadre MD Inc

  • Hematology & Oncology Physician
  • Modesto, CA
National Provider Identifier
1962677781
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A38740 Issued in CA
Legal business name
MUSSA BANISADRE MD INC
Practice address
1325 Melrose Ave
Suite a
Modesto, CA 95350-5581
Phone
(209) 527-5601
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Mr. Mussa Banisadre, MD INCNPI 1043264690
Title
MD Owner
Phone
(209) 524-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X A38740 CA Primary

Addresses

Primary practice location

1325 Melrose Ave
Suite a
Modesto, CA 95350-5581

Mailing address

1325 Melrose Ave
Suite a
Modesto, CA 95350-5581
Phone (209) 527-5601

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1962677781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 MELROSE AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505581",
            "telephone_number": "209-527-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 MELROSE AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505581",
            "telephone_number": "209-527-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSSA BANISADRE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "BANISADRE",
        "authorized_official_first_name": "MUSSA",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "209-524-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD INC"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A38740",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 11, 2008; 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.