Provider Demographics
NPI:1609880921
Name:YOUSEFIAN TEHRANI, HRAIR (MD)
Entity Type:Individual
Prefix:MR
First Name:HRAIR
Middle Name:
Last Name:YOUSEFIAN TEHRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:HRAIR
Other - Middle Name:
Other - Last Name:TEHRANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1945 N FINE STREET
Mailing Address - Street 2:#116
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1945 N FINE STREET
Practice Address - Street 2:#116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727
Practice Address - Country:US
Practice Address - Phone:559-457-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51872208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A51872OtherLICENSE #
A51872OtherLICENSE #
BY4083680OtherDEA #