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General NPI Number Information
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NPI Number | 1750774923
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Entity Type | Individual
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Provider Name | AHMADREZA GHASEMIESFE M.D
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Gender | Male
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 3233 CROCKER DR
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City | SACRAMENTO
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State | CA
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Zip | 95818-3964
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Country | US
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Telephone | 312-395-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 3233 CROCKER DR
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City | SACRAMENTO
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State | CA
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Zip | 95818-3964
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Country | US
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Telephone | 312-395-0993
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A166996
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License Number State | CA
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