Provider Demographics
NPI:1720266760
Name:JAHANGIRI, MOHAMMAD IKRAM (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:IKRAM
Last Name:JAHANGIRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2940 CAMINO DIABLO
Mailing Address - Street 2:STE 320
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597
Mailing Address - Country:US
Mailing Address - Phone:925-944-9711
Mailing Address - Fax:925-944-9709
Practice Address - Street 1:2940 CAMINO DIABLO
Practice Address - Street 2:STE 320
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597
Practice Address - Country:US
Practice Address - Phone:925-944-9711
Practice Address - Fax:925-944-9709
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA564002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ746862Medicare UPIN