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General NPI Number Information
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NPI Number | 1518006543
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Entity Type | Individual
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Provider Name | MOHAMMAD HOUMAN FEKRAZAD MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 28860 PLAZA DE ORO
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City | VALENCIA
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State | CA
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Zip | 91354-3033
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Country | US
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Telephone | 708-997-4666
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Fax |
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Provider Business Mailing Address
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Address Line | 28860 PLAZA DE ORO
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City | VALENCIA
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State | CA
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Zip | 91354-3033
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2005-0665
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD2005-0665
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License Number State | NM
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