Provider Demographics
NPI:1326360637
Name:AHMAD N HAKIMI MD PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:AHMAD N HAKIMI MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAKIMI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:559-781-9922
Mailing Address - Street 1:557 W MORTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3383
Mailing Address - Country:US
Mailing Address - Phone:559-781-9922
Mailing Address - Fax:559-781-9925
Practice Address - Street 1:557 W MORTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3383
Practice Address - Country:US
Practice Address - Phone:559-781-9922
Practice Address - Fax:559-781-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-28
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95840208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADH978AMedicare PIN