Provider Demographics
NPI:1275611360
Name:SAAD, BASHAR G (MD)
Entity Type:Individual
Prefix:
First Name:BASHAR
Middle Name:G
Last Name:SAAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:399 E HIGHLAND AVE
Mailing Address - Street 2:STE 427
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3824
Mailing Address - Country:US
Mailing Address - Phone:909-882-1210
Mailing Address - Fax:909-882-0716
Practice Address - Street 1:399 E HIGHLAND AVE
Practice Address - Street 2:STE 427
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3824
Practice Address - Country:US
Practice Address - Phone:909-882-1210
Practice Address - Fax:909-882-0716
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52007207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A520070Medicaid
CADM557AMedicare PIN
LA5W396OtherMEDICARE PROVIDER NUMBER