Organization
JAANEALI MEHDI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAANEALI MEHDI MD (OWNER)
(606) 939-2621
Entity
Organization
Contact information
Practice address
1501 CLAUS RD, MODESTO, CA 95355-9711
(209) 557-6310
Mailing address
220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
(209) 579-5628
(209) 579-5637
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C156559
STATE OF CA MEDICAL BOARD
CA
Enumeration date
03/19/2020
Last updated
09/30/2020
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