Provider Demographics
NPI:1326579947
Name:NADERI, TAHEREH KAZEMI (MD)
Entity Type:Individual
Prefix:MS
First Name:TAHEREH
Middle Name:KAZEMI
Last Name:NADERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:TAHEREH
Other - Middle Name:
Other - Last Name:MIRZAKAZEMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2950 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2228
Mailing Address - Country:US
Mailing Address - Phone:510-485-5906
Mailing Address - Fax:
Practice Address - Street 1:2950 INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-2228
Practice Address - Country:US
Practice Address - Phone:510-485-5906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine