Healthcare Provider Details

I. General information

NPI: 1174601918
Provider Name (Legal Business Name): HASHEM S. DAJANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 SONOMA BLVD
VALLEJO CA
94589-2200
US

IV. Provider business mailing address

3449 EDGEWATER PL
VALLEJO CA
94591-8398
US

V. Phone/Fax

Practice location:
  • Phone: 707-685-7410
  • Fax: 707-554-4481
Mailing address:
  • Phone: 707-685-7410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA66683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: