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Organization
MAVIE CLINIC PROFESSIONAL NURSING CORPORATION
Active
Organization
MAVIE CLINIC PROFESSIONAL NURSING CORPORATION
Active
Other names
Mavie Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MUKHTAR KOHISTANI FNP-C (PRESIDENT)
(209) 806-4841
Entity
Organization
Contact information
Practice address
109 PORTRAIT LN, PATTERSON, CA 95363-8341
(209) 806-4841
(209) 290-3320
Mailing address
109 PORTRAIT LN, PATTERSON, CA 95363-8341
(209) 806-4841
(209) 290-3320
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/23/2026
Last updated
01/26/2026
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