Basic Information
| Provider Information | |||||||||
| NPI: | 1205174513 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KAFELE T HODARI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 COHASSET RD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303423686 | ||||||||
| FaxNumber: | 5308793060 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 COHASSET RD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303423686 | ||||||||
| FaxNumber: | 5308793060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2013 | ||||||||
| LastUpdateDate: | 01/21/2013 | ||||||||
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| AuthorizedOfficialLastName: | HODARI | ||||||||
| AuthorizedOfficialFirstName: | KAFELE | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5303423686 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A104470 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.