MOHAMMED HOSAM ALDIN BACCORA (NPI# 1366567471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366567471 |
| Entity Type | Individual |
| Full Name | MOHAMMED HOSAM ALDIN BACCORA |
| Credential | MD |
| Practice Address |
1701 3rd St Se Ste 300 Puyallup WA 98372-4511 |
| Practice Telephone | 2536974740 |
| Mailing Telephone | 2536974740 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-12-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD00049133 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD00049133 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
1701 3RD ST SE STE 300 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-4511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467425330 | Nichol T Iverson | Internal Medicine | 1701 3rd St Se, Suite 300, Puyallup, WA 98372-4511 | 2006-02-09 |
| 1750597480 | Dedicated Womens Health Specialists Inc P.s. | Obstetrics & Gynecology | 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 | 2007-05-16 |
| 1235343963 | Laurie J Morris | Obstetrics & Gynecology | 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 | 2007-05-10 |
| 1215076971 | Stephen R Kerr | Specialist | 1701 3rd St Se, Suite 300, Puyallup, WA 98372-4511 | 2007-02-06 |
| 1811040173 | Joel Fausto Kliatchko Estrada | Internal Medicine | 1701 3rd St Se, Suite 300, Puyallup, WA 98372-4511 | 2007-01-19 |
| 1841393865 | Paul H Eun | Obstetrics & Gynecology | 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 | 2006-09-06 |
| 1649373663 | Kenneth Murray Edstrom | Obstetrics & Gynecology | 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 | 2006-09-06 |
| 1598778458 | Jebin Mathew Chacko | Psychiatry & Neurology | 1701 3rd St Se, Puyallup, WA 98372-4511 | 2006-08-14 |
| 1376563601 | Jessica Santiago Khan | Internal Medicine | 1701 3rd St Se, Puyallup, WA 98372-4511 | 2006-07-20 |
| 1588611313 | Charles Nam | Internal Medicine | 1701 3rd St Se, 300, Puyallup, WA 98372-4511 | 2006-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841421500 | Saritha Boyapati | Internal Medicine | 1450 5th St Se Ste 3400, Puyallup, WA 98372-4638 | 2009-07-29 |
| 1942240056 | Zhuowei Wang | Internal Medicine | 201 15th Ave Sw, Ste A, Puyallup, WA 98371-7495 | 2006-06-07 |
| 1043441082 | Franciscan Medical Group | Internal Medicine | 15214 Canyon Rd E, Ste 205, Puyallup, WA 98375-7472 | 2009-08-06 |
| 1427249010 | Rainier Nephrology Pllc | Internal Medicine | 201 15th Ave Sw, Ste A, Puyallup, WA 98371-7495 | 2007-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790326502 | Blazing Grace Medical, LLC | Internal Medicine | 953 Stevens Dr Ste C, Richland, WA 99352-3533 | 2019-10-02 |
| 1619460268 | Pacific Kidney & Hypertension, LLC | Internal Medicine | 2707 Colby Ave, Everett, WA 98201-3528 | 2018-06-08 |
| 1992258289 | Roderick Marshall Macdonald | Internal Medicine | University of Washington Mc 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2016-08-03 |
| 1124458310 | Cascade Kidney Specialists | Internal Medicine | Cascade Kidney Specialists, 1370 116th Ave Ne Suite 209, Bellevue, WA 98004-3825 | 2013-11-25 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| 1164775508 | Hoang H Dang, Md, Ps | Internal Medicine | 9804 Ne 15th St, Bellevue, WA 98004-3431 | 2012-10-23 |
| 1942561824 | Tsering Dhondup | Internal Medicine | 3525 Ensign Rd Ne Ste K, Olympia, WA 98506-5065 | 2012-06-06 |
| 1518248921 | William Griffith Couser | Internal Medicine | 16050 169th Ave Ne, Woodinville, WA 98072-8949 | 2011-08-30 |
| 1346535556 | David Alan Goodkin | Internal Medicine | 3807 134th Ave Ne, Bellevue, WA 98005-1437 | 2011-06-15 |
| 1174838676 | Shanza Mujeeb | Internal Medicine | 1708 Yakima Ave Ste 107, Tacoma, WA 98405-5300 | 2010-08-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.