# MEHRAN BAJOGHLI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699868786
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 0101231597 | VA | — |
| 207U00000X | Nuclear Medicine Physician | 07395 | VA | — |
| 208D00000X | General Practice Physician | 0101231597 | VA | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 05/24/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30016041500017 | — | VA |
| 01 | — | 6B8333 | MEDICARE | — |