Provider Demographics
NPI:1760492391
Name:KALDAS, NADER RIAD (MD)
Entity type:Individual
Prefix:
First Name:NADER
Middle Name:RIAD
Last Name:KALDAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 CONCANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6004
Mailing Address - Country:US
Mailing Address - Phone:925-443-0313
Mailing Address - Fax:925-443-0315
Practice Address - Street 1:1370 CONCANNON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6004
Practice Address - Country:US
Practice Address - Phone:925-443-0313
Practice Address - Fax:925-443-0315
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A506370Medicaid
CA00A506370Medicaid
CA00A506370Medicare ID - Type Unspecified