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General NPI Number Information
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NPI Number | 1851554208
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Entity Type | Individual
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Provider Name | SHAHAB DIAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 7202 N MILLBROOK AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93720-3341
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Country | US
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Telephone | 559-450-4463
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Fax | 559-450-4462
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Provider Business Mailing Address
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Address Line | 1111 E SPRUCE AVE STE 431
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City | FRESNO
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State | CA
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Zip | 93720-3330
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Country | US
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Telephone | 559-450-7449
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Fax | 559-450-7470
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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 | 003928
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A115541
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A115541
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License Number State | CA
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