Provider Demographics
NPI:1891032512
Name:BANIHASHEMI, BEHROOZ (MD)
Entity Type:Individual
Prefix:MR
First Name:BEHROOZ
Middle Name:
Last Name:BANIHASHEMI
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 1:4550 CALIFORNIA AVE 500
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7020
Mailing Address - Country:US
Mailing Address - Phone:661-716-3484
Mailing Address - Fax:661-716-5484
Practice Address - Street 1:4550 CALIFORNIA AVE 500
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7020
Practice Address - Country:US
Practice Address - Phone:661-716-7100
Practice Address - Fax:661-716-5484
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA134421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine