Provider Demographics
NPI:1578616520
Name:VAIDYA, NADEEM NURMOHAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:NADEEM
Middle Name:NURMOHAMED
Last Name:VAIDYA
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 1:16100 SAND CANYON AVE STE 385
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3720
Mailing Address - Country:US
Mailing Address - Phone:949-732-0201
Mailing Address - Fax:888-421-7757
Practice Address - Street 1:16100 SAND CANYON AVE STE 385
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3720
Practice Address - Country:US
Practice Address - Phone:949-732-0201
Practice Address - Fax:888-421-7757
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117865207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8681340Medicaid
XXH960262662OtherBCBS INDIVIDUAL NUMBER