Provider Demographics
NPI:1477702280
Name:BOZORGMEHR, JAFAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAFAR
Middle Name:
Last Name:BOZORGMEHR
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:PO BOX 576649
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-6649
Mailing Address - Country:US
Mailing Address - Phone:209-571-8330
Mailing Address - Fax:209-491-7184
Practice Address - Street 1:1501 CLAUS ROAD
Practice Address - Street 2:DOCTORS BEHAVIORAL HEALTH CENTER
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:916-865-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1028842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry