Healthcare Provider Details

I. General information

NPI: 1750239661
Provider Name (Legal Business Name): GREENPATH KIDNEY AND HYPERTENSION CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 ANDERSON RD STE 5
DAVIS CA
95616-3505
US

IV. Provider business mailing address

2009 BAYWOOD LN
DAVIS CA
95618-0500
US

V. Phone/Fax

Practice location:
  • Phone: 925-997-4483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAFAR ALSAID
Title or Position: CEO
Credential: MD
Phone: 925-997-4483