Provider Demographics
NPI:1326159641
Name:BOKHARI, SAYED RIAZ (MD)
Entity Type:Individual
Prefix:
First Name:SAYED
Middle Name:RIAZ
Last Name:BOKHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2067 WINERIDGE PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-1952
Mailing Address - Country:US
Mailing Address - Phone:760-740-6944
Mailing Address - Fax:760-740-9619
Practice Address - Street 1:215 S HICKORY ST
Practice Address - Street 2:STE.112
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4360
Practice Address - Country:US
Practice Address - Phone:760-740-6944
Practice Address - Fax:760-740-9619
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC51332208600000X, 2086S0102X, 2086S0127X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C513320Medicaid
CAWC51332AMedicare PIN
CAB66755Medicare UPIN