Provider Demographics
NPI:1902123383
Name:HASHEMI, PANTEA (MD)
Entity Type:Individual
Prefix:
First Name:PANTEA
Middle Name:
Last Name:HASHEMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6726
Mailing Address - Country:US
Mailing Address - Phone:916-571-5200
Mailing Address - Fax:916-571-5099
Practice Address - Street 1:650 UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-571-5200
Practice Address - Fax:916-571-5099
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132379207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology