Healthcare Provider Details

I. General information

NPI: 1487297016
Provider Name (Legal Business Name): SAJJAD BIDAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2019
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CLAYTON RD APT 203
CONCORD CA
94521-2564
US

IV. Provider business mailing address

3838 CLAYTON RD APT 203
CONCORD CA
94521-2564
US

V. Phone/Fax

Practice location:
  • Phone: 925-325-2028
  • Fax:
Mailing address:
  • Phone: 925-325-2028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: