Provider Demographics
NPI:1861071722
Name:SAAD, MARIAM J
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:J
Last Name:SAAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 CARRIAGE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1350
Mailing Address - Country:US
Mailing Address - Phone:626-261-2939
Mailing Address - Fax:
Practice Address - Street 1:1650 CARRIAGE HOUSE RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1350
Practice Address - Country:US
Practice Address - Phone:626-261-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant