Provider Demographics
NPI:1528091964
Name:JAVAID, MAZHAR (M D)
Entity type:Individual
Prefix:
First Name:MAZHAR
Middle Name:
Last Name:JAVAID
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 E ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5606
Mailing Address - Country:US
Mailing Address - Phone:559-673-9021
Mailing Address - Fax:559-673-6234
Practice Address - Street 1:120 WILGART WAY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4013
Practice Address - Country:US
Practice Address - Phone:831-424-1400
Practice Address - Fax:831-424-1441
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38439207R00000X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A384390Medicaid
CA00A384390Medicaid
CA00A384390Medicaid