Provider Demographics
NPI:1982600516
Name:VAZEEN, MEHDI (MD)
Entity type:Individual
Prefix:MR
First Name:MEHDI
Middle Name:
Last Name:VAZEEN
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 1:1104 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3803
Mailing Address - Country:US
Mailing Address - Phone:775-882-9123
Mailing Address - Fax:
Practice Address - Street 1:1104 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3803
Practice Address - Country:US
Practice Address - Phone:775-882-9123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV8939207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2013063Medicaid
NVV31825Medicare PIN
NV2013063Medicaid