Provider Demographics
NPI:1396318390
Name:ALLAHDADI MD INC
Entity type:Organization
Organization Name:ALLAHDADI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAHDADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-547-9410
Mailing Address - Street 1:836 ANACAPA ST P.O. BOX 22336
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93121
Mailing Address - Country:US
Mailing Address - Phone:916-547-9410
Mailing Address - Fax:805-569-8358
Practice Address - Street 1:400 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4353
Practice Address - Country:US
Practice Address - Phone:916-547-9410
Practice Address - Fax:805-569-8358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty