Provider Demographics
NPI:1801853353
Name:PAZOUKI, NARGES (MD)
Entity Type:Individual
Prefix:DR
First Name:NARGES
Middle Name:
Last Name:PAZOUKI
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:PO BOX 4398
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95352-4398
Mailing Address - Country:US
Mailing Address - Phone:209-575-4575
Mailing Address - Fax:209-575-4398
Practice Address - Street 1:1801 COLORADO AVE STE 250
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2710
Practice Address - Country:US
Practice Address - Phone:209-647-3950
Practice Address - Fax:209-632-3021
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA865912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A865910Medicaid
CA00A865910Medicaid
CAI20983Medicare UPIN