MEDICARE: ALI M AGHAMOHAMMADI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	A41243	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033183157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI M AGHAMOHAMMADI MD

Provider Business Mailing Address
First Line	:	2323 16TH STREET
Second Line	:	101
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-3453
Country	:	US
Telephone Number	:	661-324-3232
Fax Number	:	661-324-1236

Provider Business Practice Location Address
First Line	:	2323 16TH STREET
Second Line	:	101
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-3453
Country	:	US
Telephone Number	:	661-324-3232
Fax Number	:	661-324-1236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	08/03/2015

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