Individual
MOHSEN DAMAVAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 569-7408
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A146130
CA
208M00000X
Hospitalist Physician
Primary
A146130
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/23/2014
Last updated
07/21/2022
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