Healthcare Provider Details

I. General information

NPI: 1891389458
Provider Name (Legal Business Name): MOHAMMADAMIN ASADIRAD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 CALIFORNIA ST
WOODLAND CA
95695-2910
US

IV. Provider business mailing address

2228 LIDO CIR
STOCKTON CA
95207-6018
US

V. Phone/Fax

Practice location:
  • Phone: 530-665-4640
  • Fax: 530-665-4641
Mailing address:
  • Phone: 209-684-2978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: