Provider Demographics
NPI:1902986466
Name:SADDY, SHEHAB (MD)
Entity Type:Individual
Prefix:
First Name:SHEHAB
Middle Name:
Last Name:SADDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 UPPER RAGSDALE DR
Mailing Address - Street 2:SUITE B240
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5736
Mailing Address - Country:US
Mailing Address - Phone:831-642-9800
Mailing Address - Fax:831-642-9700
Practice Address - Street 1:2 UPPER RAGSDALE DR
Practice Address - Street 2:SUITE B240
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5736
Practice Address - Country:US
Practice Address - Phone:831-642-9800
Practice Address - Fax:831-642-9700
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA068347207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A0683470Medicaid
CA00A0683470Medicaid
CA00A683470Medicare PIN