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General NPI Number Information
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NPI Number | 1427539287
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Entity Type | Organization
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Legal Business Name | MOHAMMAD HAGHDOOST MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1144 NORMAN DR STE 204
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City | MANTECA
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State | CA
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Zip | 95336-5960
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Country | US
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Telephone | 209-665-4252
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Fax | 866-589-7497
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Provider Business Mailing Address
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Address Line | PO BOX 1227
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City | RIPON
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State | CA
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Zip | 95366-1227
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Country | US
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Telephone | 650-804-4610
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Fax | 866-589-7497
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHAMMAD HAGHDOOST
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Credential | MD
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Telephone | 650-804-4610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A111081
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License Number State | CA
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