Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A136988 | CA |
N | 208600000X | Surgeon | A136988 | CA |
Y | 2086X0206X | Surgical Oncologist | A136988 | CA |
NPI | 1396908398 |
---|---|
Provider Name | Amir Hassan Fathi |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93701-2211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 04/11/2019 |