Provider Demographics
NPI:1285861153
Name:KALANI, MOHAMMAD YASHAR S (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD YASHAR
Middle Name:S
Last Name:KALANI
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 1:2000 S WHEELING AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5656
Mailing Address - Country:US
Mailing Address - Phone:918-748-7854
Mailing Address - Fax:918-403-6335
Practice Address - Street 1:2000 S WHEELING AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5656
Practice Address - Country:US
Practice Address - Phone:918-748-7854
Practice Address - Fax:918-403-6335
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR71385207T00000X
UT9717710-1205207T00000X
VA0101262853207T00000X
OK35434207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT9717710-1205OtherUTAH STATE MEDICAL BOARD
AZR71385OtherTRAINING PERMIT