Organization
REZA VAFADOUSTE MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REZA VAFADOUSTE MD (CEO/PRESIDENT)
(209) 216-3571
Entity
Organization
Contact information
Practice address
2141 COLORADO AVE, TURLOCK, CA 95382-2011
(209) 575-4575
Mailing address
PO BOX 4398, MODESTO, CA 95352-4398
(209) 575-4575
(209) 575-4598
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A79905
CA
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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