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Individual
SHAHROD MOKHTARI
Active
Individual
SHAHROD MOKHTARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A117566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDI-CAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
07/15/2011
Last updated
09/26/2023
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