Individual
DR. MEHRDAD M.R. AMIRHAMZEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
—
P00014381
RAILROAD MEDICARE ID
CA
Enumeration date
07/21/2005
Last updated
08/19/2022
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