Provider Demographics
NPI:1346462223
Name:TEHRANI, ROUZBEH (MD)
Entity Type:Individual
Prefix:
First Name:ROUZBEH
Middle Name:
Last Name:TEHRANI
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 1:10986 CLOVERHURST WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-4819
Mailing Address - Country:US
Mailing Address - Phone:858-999-1873
Mailing Address - Fax:
Practice Address - Street 1:10986 CLOVERHURST WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-4819
Practice Address - Country:US
Practice Address - Phone:858-999-1873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine