Provider Demographics
NPI:1437186400
Name:BADRI, MOHAMAD SHARIF (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD SHARIF
Middle Name:
Last Name:BADRI
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 1:135 NORTH JACKSON AVENUE, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1917
Mailing Address - Country:US
Mailing Address - Phone:408-926-9600
Mailing Address - Fax:408-926-9645
Practice Address - Street 1:135 NORTH JACKSON AVENUE, SUITE 202
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1917
Practice Address - Country:US
Practice Address - Phone:408-926-9600
Practice Address - Fax:408-926-9645
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA302792080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABA8034Medicare UPIN