Provider Demographics
NPI:1629281233
Name:KORMI, TOURAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:TOURAJ
Middle Name:
Last Name:KORMI
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 1:2999 REGENT ST STE 425
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2119
Mailing Address - Country:US
Mailing Address - Phone:510-981-8222
Mailing Address - Fax:510-981-8228
Practice Address - Street 1:2999 REGENT ST STE 425
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2119
Practice Address - Country:US
Practice Address - Phone:510-981-8222
Practice Address - Fax:510-981-8228
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48807208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery