Healthcare Provider Details

I. General information

NPI: 1942762190
Provider Name (Legal Business Name): ZHOOBIN HEIDARI BATENI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

782 MEDICAL CENTER DR E
CLOVIS CA
93611-6889
US

IV. Provider business mailing address

PO BOX 25100
FRESNO CA
93729-5100
US

V. Phone/Fax

Practice location:
  • Phone: 559-472-4606
  • Fax:
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-421-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA179170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: