# NOUROLLAH B. GHORBANI,M.D.INC.

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

## Provider details

- **NPI number:** 1346542743
- **Authorized official:** DR. NOUROLLAH B. GHORBANI M.D. (PRESIDENT)
- **Authorized official phone:** (925) 946-9004

## Contact information

- **Practice address:** 130 LA CASA VIA, SUITE 102, WALNUT CREEK, CA 94598-3045
- **Practice address phone:** (925) 946-9004
- **Practice address fax:** (925) 946-9319
- **Mailing address:** 130 LA CASA VIA, SUITE 102, WALNUT CREEK, CA 94598-3045
- **Mailing address phone:** (925) 946-9004
- **Mailing address fax:** (925) 946-9319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A40690 | CA | Yes |

## Other

- **Enumeration date:** 11/17/2010
- **Last updated:** 11/17/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1508970682 | PHYSICIAN NPI | CA |