Provider Demographics
NPI:1407990906
Name:MANUCHEHRY, AMIR (M,D,)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:MANUCHEHRY
Suffix:
Gender:M
Credentials:M,D,
Other - Prefix:DR
Other - First Name:AMIR
Other - Middle Name:
Other - Last Name:ISLAMI-MANUCHEHRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2420 CAMINO RAMON
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-543-0140
Mailing Address - Fax:
Practice Address - Street 1:2420 CAMINO RAMON
Practice Address - Street 2:SUITE 270
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-543-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225892207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology