Provider Demographics
NPI:1760463558
Name:EMAMI, AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:EMAMI
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 1:7565 N CEDAR AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2687
Mailing Address - Country:US
Mailing Address - Phone:559-438-8888
Mailing Address - Fax:559-438-8887
Practice Address - Street 1:7565 N CEDAR AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2687
Practice Address - Country:US
Practice Address - Phone:559-438-8888
Practice Address - Fax:559-438-8887
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A548780Medicaid
CA080157560OtherRAILROAD MEDICARE
CA00A548780OtherBLUE CROSS/BLUE SHIELD
CA00A548780Medicaid
CA080157560OtherRAILROAD MEDICARE