MEDICARE: DR. MOHAMMED SHAHZAD QAYYUM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	A56213	CA

General Provider Information

NPI Number	:	1679666994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED SHAHZAD QAYYUM MD

Provider Business Mailing Address
First Line	:	2550 SAMARITAN DR
Second Line	:	SUITE D
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4104
Country	:	US
Telephone Number	:	408-610-2001
Fax Number	:	408-610-3880

Provider Business Practice Location Address
First Line	:	2550 SAMARITAN DR
Second Line	:	SUITE D
City	:	SAN JOSE
State	:	CA
Zip	:	95124-4104
Country	:	US
Telephone Number	:	408-610-2001
Fax Number	:	408-610-3880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	03/18/2025

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