Provider Demographics
NPI:1588004634
Name:HAJSADEGHI, FERESHTEH (MD)
Entity Type:Individual
Prefix:DR
First Name:FERESHTEH
Middle Name:
Last Name:HAJSADEGHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20757 BERMUDA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1502
Mailing Address - Country:US
Mailing Address - Phone:562-852-0099
Mailing Address - Fax:
Practice Address - Street 1:20757 BERMUDA ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1502
Practice Address - Country:US
Practice Address - Phone:562-852-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125063271208000000X
CA257597207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics