Provider Demographics
NPI:1932183159
Name:JAVID, ATHIYA D (MD)
Entity Type:Individual
Prefix:
First Name:ATHIYA
Middle Name:D
Last Name:JAVID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N JACKSON AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1903
Mailing Address - Country:US
Mailing Address - Phone:408-844-9670
Mailing Address - Fax:408-844-9671
Practice Address - Street 1:125 N JACKSON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1903
Practice Address - Country:US
Practice Address - Phone:408-844-9670
Practice Address - Fax:408-844-9671
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF02133Medicare UPIN
CA00A447270Medicare ID - Type Unspecified