| Kasaji Medical Pc | |
|
5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 | |
| (704) 548-7962 | |
| (704) 613-3431 |
| Full Name | Kasaji Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5820 E W T Harris Blvd Ste B, Charlotte, North Carolina |
| Authorized Official Name and Position | Mohammad Kasaji (PRESIDENT) |
| Authorized Official Contact | 9145899963 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kasaji Medical Pc 5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 Ph: () - | Kasaji Medical Pc 5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 Ph: (704) 548-7962 |
| NPI Number | 1679263552 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 08/13/2024 |
| Medicare PECOS PAC ID | 2466815600 |
|---|---|
| Medicare Enrollment ID | O20230905004186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679263552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Mohammad Kasaji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194987677 PECOS PAC ID: 9739313602 Enrollment ID: I20190327000225 |
| Provider Name | Leslie Castillo Navia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447092697 PECOS PAC ID: 8527507441 Enrollment ID: I20240823000363 |
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