Provider Demographics
NPI:1316090640
Name:MORSHEDI, MOJGAN (MD)
Entity type:Individual
Prefix:DR
First Name:MOJGAN
Middle Name:
Last Name:MORSHEDI
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 1:14981 NATIONAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2600
Mailing Address - Country:US
Mailing Address - Phone:408-358-0444
Mailing Address - Fax:408-358-0446
Practice Address - Street 1:14981 NATIONAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2600
Practice Address - Country:US
Practice Address - Phone:408-358-0444
Practice Address - Fax:408-358-0446
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACO015AMedicare UPIN