| Mahshid Michelle Hamidi, A Medical Corporation | |
|
5222 Balboa Ave Ste 31 San Diego CA 92117-6952 | |
| (858) 565-6394 | |
| (858) 605-6719 |
| Full Name | Mahshid Michelle Hamidi, A Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 5222 Balboa Ave Ste 31, San Diego, California |
| Authorized Official Name and Position | Mahshid Michelle Hamidi (PRESIDENT) |
| Authorized Official Contact | 6194430282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahshid Michelle Hamidi, A Medical Corporation 5222 Balboa Ave Ste 31 San Diego CA 92117-6952 Ph: (858) 565-6394 | Mahshid Michelle Hamidi, A Medical Corporation 5222 Balboa Ave Ste 31 San Diego CA 92117-6952 Ph: (858) 565-6394 |
| NPI Number | 1366964488 |
|---|---|
| Provider Enumeration Date | 07/11/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5597037101 |
|---|---|
| Medicare Enrollment ID | O20170816004095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366964488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A63702 (California) | Primary |
| Provider Name | Mahshid Michelle Hamidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174534101 PECOS PAC ID: 2264690486 Enrollment ID: I20120220000690 |
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