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General NPI Number Information
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NPI Number | 1295482677
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Entity Type | Organization
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Legal Business Name | KAYHAN BANGASH MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 924 EMILY WAY
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City | MADERA
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State | CA
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Zip | 93637-5647
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Country | US
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Telephone | 559-395-4009
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Fax |
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Provider Business Mailing Address
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Address Line | 924 EMILY WAY
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City | MADERA
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State | CA
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Zip | 93637-5647
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Country | US
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Telephone | 559-395-4009
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAYHAN BANGASH
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Credential | MD
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Telephone | 559-301-0642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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