Provider Demographics
NPI:1306536875
Name:AHTSHAM, YASAR (MD)
Entity type:Individual
Prefix:
First Name:YASAR
Middle Name:
Last Name:AHTSHAM
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:DIPUTADO RICARDO VALENZUELA SAEZ 597
Mailing Address - Street 2:PARQUE BALUARTE, REGION LIBERTADOR BERNARDO OHIGGINS
Mailing Address - City:RENGO
Mailing Address - State:RENGO
Mailing Address - Zip Code:294000
Mailing Address - Country:CL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DIPUTADO RICARDO VALENZUELA SAEZ 597
Practice Address - Street 2:PARQUE BALUARTE, REGION LIBERTADOR BERNARDO OHIGGINS
Practice Address - City:RENGO
Practice Address - State:RENGO
Practice Address - Zip Code:2940000
Practice Address - Country:CL
Practice Address - Phone:005-694-9929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program