Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mussa Banisadre, MD

Individual provider Hematology & Oncology Physician · NPI 1043264690

Mussa Banisadre, MD is a Hematology in Modesto, California. Qualified in 1973, 53 years ago. Practices with Stockton Hematology Oncology Medical Group Inc, a 9-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
53
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1325 Melrose Ave Ste A
Modesto, CA 95350-5508
Phone: (209) 524-7000
Fax: (209) 527-5601
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hematology & Oncology Physician (primary) Taxonomy 207RH0003X · Licence A38740 (CA)

Record details

NPI number1043264690
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 19, 2006
Last updated in NPPESApril 14, 2008
Mailing address1325 Melrose Ave, Suite A, Modesto, CA 95350-5508

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHEMATOLOGY
Medical schoolOTHER
Graduated 1973 (53 years in practice)
Group practice Stockton Hematology Oncology Medical Group Inc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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