Provider Demographics
NPI:1083696439
Name:NASEEM, SHAHZAD (MD)
Entity Type:Individual
Prefix:
First Name:SHAHZAD
Middle Name:
Last Name:NASEEM
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 A D
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95992-1396
Mailing Address - Country:US
Mailing Address - Phone:530-751-3769
Mailing Address - Fax:530-751-1237
Practice Address - Street 1:931 MARKET ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4210
Practice Address - Country:US
Practice Address - Phone:530-671-8820
Practice Address - Fax:530-671-8410
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75541208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH98815Medicare UPIN