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General NPI Number Information
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NPI Number | 1548524960
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Entity Type | Organization
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Legal Business Name | HANFORD DERMATOLOGY AND SKIN CANCER PC
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 400 N IRWIN ST
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City | HANFORD
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State | CA
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Zip | 93230-4426
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Country | US
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Telephone | 559-584-2700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 496084
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City | REDDING
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State | CA
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Zip | 96049-6084
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Country | US
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Telephone | 559-584-2700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL TAHERI
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Credential | MD
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Telephone | 559-584-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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