Provider Demographics
NPI:1114474509
Name:DANESHBOD, BAHAREH (DC)
Entity Type:Individual
Prefix:DR
First Name:BAHAREH
Middle Name:
Last Name:DANESHBOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TOWN CENTER PKWY
Mailing Address - Street 2:MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-5801
Mailing Address - Country:US
Mailing Address - Phone:619-445-6200
Mailing Address - Fax:
Practice Address - Street 1:120 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-5801
Practice Address - Country:US
Practice Address - Phone:619-445-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor