Healthcare Provider Details

I. General information

NPI: 1659781854
Provider Name (Legal Business Name): ALIREZA SOLEIMANI FARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 FRESNO ST
FRESNO CA
93721-1324
US

IV. Provider business mailing address

685 W ALLUVIAL AVE STE 103
FRESNO CA
93711-5779
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6450
  • Fax:
Mailing address:
  • Phone: 559-499-1233
  • Fax: 559-499-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA146696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: