Healthcare Provider Details

I. General information

NPI: 1023429412
Provider Name (Legal Business Name): NADIA JAVAID M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 SHAW AVE STE 101
CLOVIS CA
93611-4192
US

IV. Provider business mailing address

2006 SHAW AVE STE 101
CLOVIS CA
93611-4192
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-5880
  • Fax: 559-450-5881
Mailing address:
  • Phone: 559-450-5880
  • Fax: 559-450-5881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA146164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: