Basic Information
Provider Information
NPI: 1619400678
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OBEID
FirstName: SARA
MiddleName: THABIT MAKKI
NamePrefix: MRS.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 505 PARNASSUS AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432204
CountryCode: US
TelephoneNumber: 5104375039
FaxNumber: 5105357313
Practice Location
Address1: 1411 E 31ST ST
Address2: 2ND FLOOR A2
City: OAKLAND
State: CA
PostalCode: 946021018
CountryCode: US
TelephoneNumber: 5104375039
FaxNumber: 5105357313
Other Information
ProviderEnumerationDate: 04/06/2017
LastUpdateDate: 02/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA164548CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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