Provider Demographics
NPI:1194708099
Name:IRANI, HORMUZ (MD)
Entity type:Individual
Prefix:DR
First Name:HORMUZ
Middle Name:
Last Name:IRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 TRUXTUN AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0435
Mailing Address - Country:US
Mailing Address - Phone:661-638-0601
Mailing Address - Fax:661-638-0605
Practice Address - Street 1:5959 TRUXTUN AVE
Practice Address - Street 2:STE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0435
Practice Address - Country:US
Practice Address - Phone:661-638-0601
Practice Address - Fax:661-638-0605
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41148208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A411480Medicaid
CA00A411480Medicare PIN