Provider Demographics
NPI:1952527319
Name:HODARI, KAFELE T (MD)
Entity Type:Individual
Prefix:DR
First Name:KAFELE
Middle Name:T
Last Name:HODARI
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 1:80 DECLARATION DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4900
Mailing Address - Country:US
Mailing Address - Phone:530-894-6832
Mailing Address - Fax:530-342-4199
Practice Address - Street 1:80 DECLARATION DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4900
Practice Address - Country:US
Practice Address - Phone:530-894-6832
Practice Address - Fax:530-342-4199
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200915207N00000X, 207NI0002X, 207NS0135X, 207R00000X
CAA104470207NI0002X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine