Provider Demographics
NPI:1821298365
Name:MOINIZANDI, TARLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TARLAN
Middle Name:
Last Name:MOINIZANDI
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 1:450 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3513
Mailing Address - Country:US
Mailing Address - Phone:559-585-5010
Mailing Address - Fax:559-585-1012
Practice Address - Street 1:450 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3513
Practice Address - Country:US
Practice Address - Phone:559-585-5010
Practice Address - Fax:559-585-1012
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108597207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine