Provider Demographics
NPI:1356348387
Name:MEHDI, ABBAS (MD)
Entity type:Individual
Prefix:DR
First Name:ABBAS
Middle Name:
Last Name:MEHDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7585 N CEDAR AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2604
Mailing Address - Country:US
Mailing Address - Phone:559-243-1232
Mailing Address - Fax:559-243-9954
Practice Address - Street 1:7585 N CEDAR AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2604
Practice Address - Country:US
Practice Address - Phone:559-243-1232
Practice Address - Fax:559-243-9954
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA667692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A667690Medicaid
CA00A667690Medicare PIN
CAH43246Medicare UPIN