Organization
MEHRDAD AMIRHAMZEH, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHRDAD AMIRHAMZEH M.D. (PRESIDENT)
(209) 665-4412
Entity
Organization
Contact information
Practice address
1610 W YOSEMITE AVE, SUITE 3, MANTECA, CA 95337-5189
(209) 665-4412
(209) 665-4415
Mailing address
1610 W YOSEMITE AVE, SUITE 3, MANTECA, CA 95337-5189
(209) 665-4412
(209) 665-4415
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G86572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G865720
—
CA
01
—
ZZZ03769Z
MEDICARE PTAN
—
Enumeration date
08/31/2006
Last updated
08/22/2013
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