Basic Information
| Provider Information | |||||||||
| NPI: | 1952527319 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HODARI | ||||||||
| FirstName: | KAFELE | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 COHASSET RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308946832 | ||||||||
| FaxNumber: | 5303424199 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 DECLARATION DR | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959734900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308946832 | ||||||||
| FaxNumber: | 5303424199 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | MD.200915 | LA | N | Allopathic & Osteopathic Physicians | Dermatology | 207NI0002X | A104470 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | Clinical & Laboratory Dermatological Immunology | 207NI0002X | MD.200915 | LA | N | Allopathic & Osteopathic Physicians | Dermatology | Clinical & Laboratory Dermatological Immunology | 207NS0135X | A104470 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 207NS0135X | MD.200915 | LA | N | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 207R00000X | MD.200915 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207N00000X | A104470 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.