Individual
HAJRA I TILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A98974
CA
207RR0500X
Rheumatology Physician
Primary
A98974
CA
Other
Enumeration date
02/15/2008
Last updated
05/13/2010
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