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General NPI Number Information
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NPI Number | 1720032808
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Entity Type | Individual
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Provider Name | OMID HAJISEYEDJAVADI MD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 105 N BASCOM AVE STE 202
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City | SAN JOSE
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State | CA
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Zip | 95128-1811
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Country | US
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Telephone | 408-356-7205
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Fax |
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Provider Business Mailing Address
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Address Line | 16696 CYPRESS WAY
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City | LOS GATOS
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State | CA
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Zip | 95030-7531
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Country | US
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Telephone | 408-896-9450
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Fax | 408-213-7621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 101490
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 24220
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 44129
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 036.130433
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 165090
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License Number State | MT
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Taxonomy #6
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | C55150
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License Number State | CA
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