Individual
MOHAMMAD MATTHEW FAKHRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 POTRERO AVENUE, BUILDING 5, 1ST FLOOR, SAN FRANCISCO, CA 94110-3518
(628) 206-8000
Mailing address
PO BOX 743749, LOS ANGELES, CA 90074-3749
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2019025008
MO
2085R0202X
Diagnostic Radiology Physician
Primary
A165736
CA
282N00000X
General Acute Care Hospital
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Other
Enumeration date
03/26/2016
Last updated
06/22/2022
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