Provider Demographics
NPI:1174601918
Name:DAJANI, HASHEM S (MD)
Entity type:Individual
Prefix:
First Name:HASHEM
Middle Name:S
Last Name:DAJANI
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 1:3449 EDGEWATER PL
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8398
Mailing Address - Country:US
Mailing Address - Phone:707-685-7410
Mailing Address - Fax:
Practice Address - Street 1:4300 SONOMA BLVD
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2200
Practice Address - Country:US
Practice Address - Phone:707-685-7410
Practice Address - Fax:707-554-4481
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66683207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A666830Medicaid
00A666830Medicare ID - Type Unspecified
CA00A666830Medicaid