Healthcare Provider Details

I. General information

NPI: 1629745336
Provider Name (Legal Business Name): MAHDA ALIHASHEMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date: 04/01/2022
Reactivation Date: 05/23/2022

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

IV. Provider business mailing address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-3000
  • Fax:
Mailing address:
  • Phone: 559-450-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA206384
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: