# ETESAM MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164363727
- **Authorized official:** ARSHIA ETESAM M.D. (PRESIDENT)
- **Authorized official phone:** (703) 798-3404

## Contact information

- **Practice address:** 4232 WITHERBY ST, SAN DIEGO, CA 92103-1133
- **Practice address phone:** (619) 797-6746
- **Mailing address:** 4232 WITHERBY ST, SAN DIEGO, CA 92103-1133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2026
- **Last updated:** 04/06/2026