Provider Demographics
NPI:1841797248
Name:AHMAD, JAWAD NAZIR (MD)
Entity Type:Individual
Prefix:
First Name:JAWAD
Middle Name:NAZIR
Last Name:AHMAD
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 1:3855 BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7109
Mailing Address - Country:US
Mailing Address - Phone:805-545-7881
Mailing Address - Fax:805-548-8785
Practice Address - Street 1:3855 BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7109
Practice Address - Country:US
Practice Address - Phone:805-545-8100
Practice Address - Fax:805-548-8785
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA177942207WX0009X, 207W00000X
CA177942207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist