Provider Demographics
NPI:1679737522
Name:GILDA TAFRESHI, MD
Entity Type:Organization
Organization Name:GILDA TAFRESHI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STROKE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFRESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-877-2411
Mailing Address - Street 1:4033 3RD AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2117
Mailing Address - Country:US
Mailing Address - Phone:718-877-2411
Mailing Address - Fax:
Practice Address - Street 1:4033 3RD AVENUE
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:718-877-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103111282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital