Provider Demographics
NPI:1871920652
Name:BADR MEDICAL CORPORATION
Entity type:Organization
Organization Name:BADR MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASER
Authorized Official - Middle Name:
Authorized Official - Last Name:BADR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-827-3898
Mailing Address - Street 1:PO BOX 41926
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-0926
Mailing Address - Country:US
Mailing Address - Phone:818-562-6400
Mailing Address - Fax:848-562-6405
Practice Address - Street 1:1500 E CHEVY CHASE DR STE 204
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4152
Practice Address - Country:US
Practice Address - Phone:818-827-3898
Practice Address - Fax:818-827-3897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1275724320OtherNPI
MI1507881Medicaid
MI1507881Medicaid