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General NPI Number Information
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NPI Number | 1245736719
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Entity Type | Individual
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Provider Name | MOHAMMAD K HAMIDI MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 2505 W HAMMER LN
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City | STOCKTON
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State | CA
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Zip | 95209-2839
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Country | US
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Telephone | 279-203-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 6098 KINGSMILL TER
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City | DUBLIN
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State | CA
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Zip | 94568-7778
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A173890
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License Number State | CA
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