MEDICARE: HASHEM S. DAJANI 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	207RN0300X	Nephrology Physician	A66683	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	:	1174601918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HASHEM S. DAJANI MD

Provider Business Mailing Address
First Line	:	3449 EDGEWATER PL
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94591-8398
Country	:	US
Telephone Number	:	707-685-7410
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 SONOMA BLVD
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94589-2200
Country	:	US
Telephone Number	:	707-685-7410
Fax Number	:	707-554-4481

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/27/2023

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