Provider Demographics
NPI:1619136835
Name:MONJAZEB, ARTA MONIR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ARTA
Middle Name:MONIR
Last Name:MONJAZEB
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 X STREET, G120
Mailing Address - Street 2:UC DAVIS HEALTH SYSTEM DEPARTMENT OF RADIATION ONCOLOGY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-0000
Mailing Address - Country:US
Mailing Address - Phone:336-575-2977
Mailing Address - Fax:
Practice Address - Street 1:4501 X STREET, G120
Practice Address - Street 2:UC DAVIS HEALTH SYSTEM DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-0000
Practice Address - Country:US
Practice Address - Phone:336-575-2977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1139202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60082BMedicare UPIN