Provider Demographics
NPI:1881119501
Name:MOHAMMADI, ORANUS (MD)
Entity type:Individual
Prefix:
First Name:ORANUS
Middle Name:
Last Name:MOHAMMADI
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 1:609 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3548
Mailing Address - Country:US
Mailing Address - Phone:1530-760-8966
Mailing Address - Fax:
Practice Address - Street 1:6121 N THESTA ST STE 204
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5294
Practice Address - Country:US
Practice Address - Phone:559-438-7390
Practice Address - Fax:559-438-7166
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423689207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA91722873F15357Medicaid