Provider Demographics
NPI:1780858852
Name:HOJJATI, MOHAMMAD REZA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:REZA
Last Name:HOJJATI
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:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85244-0756
Mailing Address - Country:US
Mailing Address - Phone:480-476-8750
Mailing Address - Fax:480-476-8749
Practice Address - Street 1:2680 S VAL VISTA DR STE 187
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1674
Practice Address - Country:US
Practice Address - Phone:480-476-8750
Practice Address - Fax:480-476-8749
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46481207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ722920Medicaid
AZZ90192Medicare PIN