Provider Demographics
NPI:1295740173
Name:BALADI, NAOUM A (MD)
Entity type:Individual
Prefix:DR
First Name:NAOUM
Middle Name:A
Last Name:BALADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1800 SULLIVAN AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2231
Mailing Address - Country:US
Mailing Address - Phone:650-636-4462
Mailing Address - Fax:650-636-4463
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2231
Practice Address - Country:US
Practice Address - Phone:650-636-4462
Practice Address - Fax:650-636-4463
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV30663208G00000X
CAA43839208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43839OtherLICENSE
CAA29741Medicare UPIN