Provider Demographics
NPI:1619281201
Name:PARHAM GHARAGOZLOU MD INC
Entity Type:Organization
Organization Name:PARHAM GHARAGOZLOU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARAGOZLOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-849-6634
Mailing Address - Street 1:3108 WILLOW PASS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2325
Mailing Address - Country:US
Mailing Address - Phone:925-849-6634
Mailing Address - Fax:925-849-6635
Practice Address - Street 1:3108 WILLOW PASS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2325
Practice Address - Country:US
Practice Address - Phone:925-849-6634
Practice Address - Fax:925-849-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92636207R00000X, 207RS0012X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty