Provider Demographics
NPI:1316956279
Name:SYED, ALAM NISAR MEHDI (MD)
Entity type:Individual
Prefix:DR
First Name:ALAM
Middle Name:NISAR MEHDI
Last Name:SYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:A.M.
Other - Middle Name:NISAR
Other - Last Name:SYED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2650 ELM AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1651
Mailing Address - Country:US
Mailing Address - Phone:562-492-6695
Mailing Address - Fax:562-988-0389
Practice Address - Street 1:2801N. ATLANTIC AVENUE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90801
Practice Address - Country:US
Practice Address - Phone:562-933-0300
Practice Address - Fax:562-933-0301
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAA293212085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A293210Medicaid
CAA29321OtherLICENSE
CAA29321OtherLICENSE
WA29321CMedicare ID - Type Unspecified
AS6958827OtherDEA
CAA29321OtherLICENSE
WA29321FMedicare ID - Type Unspecified
00A293210Medicare ID - Type Unspecified