Provider Demographics
NPI:1760695761
Name:NAHEEDY, JOHN HAMID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HAMID
Last Name:NAHEEDY
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 1:725 WELCH RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1601
Mailing Address - Country:US
Mailing Address - Phone:650-497-8000
Mailing Address - Fax:
Practice Address - Street 1:8745 AERO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1761
Practice Address - Country:US
Practice Address - Phone:858-565-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY568252085P0229X
CAA998322085P0229X, 2085R0202X
CODR.00681612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75341ZMedicaid
CAGR0083811Medicaid
CAGR0083813Medicaid
CAGR0083815Medicaid
CAGR0083810Medicaid
CAGR0083812Medicaid
CAGR0083814Medicaid
CAGR0083816Medicaid
CAGR0083817Medicaid
CAGR0083813Medicaid
CAW529Medicare PIN
CATP110AMedicare PIN
CATD009BMedicare PIN
CAGR0083816Medicaid
CAGR0083814Medicaid
CAZZZ75341ZMedicaid
CAGR0083810Medicaid
CAHW529Medicare PIN