Provider Demographics
NPI:1609974203
Name:ELSAYED VON BAYREUTH, ALAAELDEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAAELDEEN
Middle Name:M
Last Name:ELSAYED VON BAYREUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALAAELDEEN
Other - Middle Name:M
Other - Last Name:ELSAYED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:718 ANTRIM LN
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-8506
Mailing Address - Country:US
Mailing Address - Phone:206-953-3537
Mailing Address - Fax:
Practice Address - Street 1:101 BODIN CIR
Practice Address - Street 2:
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535
Practice Address - Country:US
Practice Address - Phone:707-423-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037672207ZF0201X, 2083A0100X, 2083P0011X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine