Healthcare Provider Details

I. General information

NPI: 1629026174
Provider Name (Legal Business Name): MOHAMMED KASHANI-SABET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 CLAY STREET 2ND FLOOR
SAN FRANCISCO CA
94115-1932
US

IV. Provider business mailing address

2340 CLAY STREET 2ND FLOOR
SAN FRANCISCO CA
94115-1932
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-3800
  • Fax: 415-600-3865
Mailing address:
  • Phone: 415-600-3800
  • Fax: 415-600-3865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG75803
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: