Basic Information
| Provider Information | |||||||||
| NPI: | 1396318390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLAHDADI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 ANACAPA ST P.O. BOX 22336 | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697315 | ||||||||
| FaxNumber: | 8055698358 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 W PUEBLO ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931054353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697315 | ||||||||
| FaxNumber: | 8055698358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2021 | ||||||||
| LastUpdateDate: | 12/07/2021 | ||||||||
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| AuthorizedOfficialLastName: | ALLAHDADI | ||||||||
| AuthorizedOfficialFirstName: | BASHIR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8055697315 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.