Provider Demographics
NPI:1699705400
Name:NADJMABADI, ESMAIL (MD)
Entity type:Individual
Prefix:DR
First Name:ESMAIL
Middle Name:
Last Name:NADJMABADI
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 1:300 OLD RIVER RD STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9512
Mailing Address - Country:US
Mailing Address - Phone:661-301-7519
Mailing Address - Fax:661-491-3459
Practice Address - Street 1:300 OLD RIVER RD STE 150
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9512
Practice Address - Country:US
Practice Address - Phone:661-301-7519
Practice Address - Fax:661-491-3459
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00013085OtherMEDICARE RAILROAD
CA00A564560Medicaid
CA00A564560Medicaid
CAP00013085OtherMEDICARE RAILROAD