Provider Demographics
NPI:1033225388
Name:ATTARAN, HOMAYOUN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOMAYOUN
Middle Name:
Last Name:ATTARAN
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:PO BOX 3084
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-8084
Mailing Address - Country:US
Mailing Address - Phone:925-362-8292
Mailing Address - Fax:
Practice Address - Street 1:919 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 158
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4050
Practice Address - Country:US
Practice Address - Phone:925-362-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64776208200000X, 2082S0099X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG64380Medicare UPIN
CA00G647761Medicare ID - Type Unspecified