Provider Demographics
NPI:1235163569
Name:NEJAD, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:NEJAD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 ROWLAND WAY
Mailing Address - Street 2:STE 215
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5011
Mailing Address - Country:US
Mailing Address - Phone:415-493-3311
Mailing Address - Fax:415-493-3302
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-925-7545
Practice Address - Fax:415-925-7008
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA81470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH96830Medicare UPIN