# MOBIN GHAVAMI MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225600653
- **Authorized official:** MOBIN GHAVAMI MD (MD OWNER)
- **Authorized official phone:** (209) 333-2500

## Contact information

- **Practice address:** 900 S FAIRMONT AVE STE A, LODI, CA 95240-5143
- **Practice address phone:** (209) 333-2500
- **Mailing address:** PO BOX 331, WOODBRIDGE, CA 95258-0331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 261QE0002X | Emergency Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/14/2021
- **Last updated:** 07/14/2021