Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | A30279 | CA |
NPI | 1437186400 |
---|---|
Provider Name | Mohamad Sharif Badri |
First Address | San Jose, CA 95116-1917 |
Second Address | San Jose, CA 95116-1917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BA8034 | (02) | CA |