Provider Demographics
NPI:1003376815
Name:GHOFRANIAN, ATOOSA (MD)
Entity Type:Individual
Prefix:
First Name:ATOOSA
Middle Name:
Last Name:GHOFRANIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5595 CAMINO DE BRYANT
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4207
Mailing Address - Country:US
Mailing Address - Phone:714-809-2532
Mailing Address - Fax:
Practice Address - Street 1:5595 CAMINO DE BRYANT
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-4207
Practice Address - Country:US
Practice Address - Phone:714-809-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program