Healthcare Provider Details
I. General information
NPI: 1578889069
Provider Name (Legal Business Name): ARAM SHEMMASSIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2010
Last Update Date: 12/15/2021
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US
IV. Provider business mailing address
2037 W ELLERY WAY
FRESNO CA
93711-1825
US
V. Phone/Fax
- Phone: 559-353-5803
- Fax:
- Phone: 818-749-7846
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | A125529 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: