Provider Demographics
NPI:1447228259
Name:JAFFER, SAEED NAWAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SAEED
Middle Name:NAWAZ
Last Name:JAFFER
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 1:262 W BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1906
Mailing Address - Country:US
Mailing Address - Phone:626-653-2525
Mailing Address - Fax:626-653-0808
Practice Address - Street 1:262 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1906
Practice Address - Country:US
Practice Address - Phone:626-653-2525
Practice Address - Fax:626-653-0808
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74086207ND0101X, 207ND0900X, 207NP0225X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A740860Medicaid
CA00A740860Medicaid
CAH35928Medicare UPIN
CAP00674761Medicare PIN
CAAU156Medicare PIN
CAWA74086AMedicare PIN