Provider Demographics
NPI:1891908869
Name:DELBAKHSH, PARVANEH (MD)
Entity Type:Individual
Prefix:DR
First Name:PARVANEH
Middle Name:
Last Name:DELBAKHSH
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 1:731 S BEACON ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3738
Mailing Address - Country:US
Mailing Address - Phone:310-732-5887
Mailing Address - Fax:310-732-5890
Practice Address - Street 1:731 S BEACON ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3738
Practice Address - Country:US
Practice Address - Phone:310-732-5887
Practice Address - Fax:310-732-5890
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63341208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics