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General NPI Number Information
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NPI Number | 1417077983
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Entity Type | Individual
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Provider Name | M MEHDI GHAJARNIA MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 1360 E HERNDON AVENUE SUITE 301
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City | FRESNO
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State | CA
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Zip | 93720-3326
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Country | US
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Telephone | 559-486-5000
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Fax | 559-439-7854
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Provider Business Mailing Address
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Address Line | 1360 E HERNDON AVENUE SUITE 301
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City | FRESNO
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State | CA
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Zip | 93720-3326
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Country | US
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Telephone | 559-486-5000
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Fax | 559-439-7854
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A103681
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MT184548
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License Number State | PA
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