Provider Demographics
NPI:1326010182
Name:ASHRAFZADEH, MOHAMMAD TAGHI (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:TAGHI
Last Name:ASHRAFZADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3220 SUNDANCE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-7324
Mailing Address - Country:US
Mailing Address - Phone:209-551-8756
Mailing Address - Fax:209-551-8756
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:112 I
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:916-843-7072
Practice Address - Fax:916-364-0187
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA53950207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology