Individual provider Active NPI

David Norman Tashjian, MD

  • Dermatology Physician
  • Fresno, CA
National Provider Identifier
1093790917
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C41281 Issued in CA
Practice address
1290 E Spruce Ave
#101
Fresno, CA 93720-3371
Phone
(559) 431-2397
Fax
(559) 435-2132
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X C41281 CA Primary

Addresses

Primary practice location

1290 E Spruce Ave
#101
Fresno, CA 93720-3371

Mailing address

1290 E Spruce Ave
#101
Fresno, CA 93720-3371
Phone (559) 431-2397

Other identifiers 1

IdentifierTypeStateIssuer
00C412810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120002781 CA Order and Referring Only - DermatologyPractitioner - Dermatology 7315189719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093790917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 E SPRUCE AVE",
            "address_2": "#101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203371",
            "telephone_number": "559-431-2397",
            "fax_number": "559-435-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 E SPRUCE AVE",
            "address_2": "#101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203371",
            "telephone_number": "559-431-2397",
            "fax_number": "559-435-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASHJIAN",
        "first_name": "DAVID",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C41281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C412810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.