Provider Demographics
NPI:1053656322
Name:SHAHINFAR MD INC
Entity Type:Organization
Organization Name:SHAHINFAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATAYOON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHINFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-779-6663
Mailing Address - Street 1:7125 N CHESTNUT AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0358
Mailing Address - Country:US
Mailing Address - Phone:559-549-7337
Mailing Address - Fax:559-297-7624
Practice Address - Street 1:7125 N CHESTNUT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0358
Practice Address - Country:US
Practice Address - Phone:559-549-7337
Practice Address - Fax:559-297-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42736261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care