Provider Demographics
NPI:1619149416
Name:DEHKORDI, ROYA KHEIRKHAH (MD)
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:KHEIRKHAH
Last Name:DEHKORDI
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 1:1729 N OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2501
Mailing Address - Country:US
Mailing Address - Phone:209-634-9034
Mailing Address - Fax:
Practice Address - Street 1:1729 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2501
Practice Address - Country:US
Practice Address - Phone:209-634-9034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 102851207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology