Provider Demographics
NPI:1073541512
Name:ALAM, SYED (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-0379
Mailing Address - Country:US
Mailing Address - Phone:661-324-7300
Mailing Address - Fax:661-869-2003
Practice Address - Street 1:2901 SILLECT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6370
Practice Address - Country:US
Practice Address - Phone:661-324-7300
Practice Address - Fax:661-869-2003
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53309207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10939943OtherCAQH
CA00A533090Medicaid
CA5622630001Medicare NSC
CA10939943OtherCAQH
CAF72456Medicare UPIN