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General NPI Number Information
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NPI Number | 1720474281
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Entity Type | Individual
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Provider Name | SADEED JAWAD M.D
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Gender | Male
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Dates
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Enumeration Date | 04/11/2015
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 2347 DAYBREAK DR
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City | LA VERNE
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State | CA
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Zip | 91750-1740
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Country | US
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Telephone | 978-578-9104
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Fax |
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Provider Business Mailing Address
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Address Line | 2347 DAYBREAK DR
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City | LA VERNE
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State | CA
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Zip | 91750-1740
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Country | US
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Telephone | 978-578-9104
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Fax | 916-581-8729
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 60779046
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A163296
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License Number State | CA
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