Provider Demographics
NPI:1790585016
Name:HEDAYATI, MASIH
Entity type:Individual
Prefix:
First Name:MASIH
Middle Name:
Last Name:HEDAYATI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLAT 33 MILLPOND COURT 43 WATERMILL LANE EDMONTON
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:LONDON
Mailing Address - Zip Code:N181ER
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FLAT 33 MILLPOND COURT 43 WATERMILL LANE EDMONTON
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:LONDON
Practice Address - Zip Code:N181ER
Practice Address - Country:GB
Practice Address - Phone:720-317-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program