Healthcare Provider Details

I. General information

NPI: 1720413123
Provider Name (Legal Business Name): KEIVAN DARYANI SAEED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

PO BOX 7540
VISALIA CA
93290-7540
US

V. Phone/Fax

Practice location:
  • Phone: 559-909-0264
  • Fax:
Mailing address:
  • Phone: 559-909-0264
  • Fax: 559-732-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD19844
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA136204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: