Individual
DR. AMIR HOSSEIN MORTAZAVIENTESAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78120 WILDCAT DR, PALM DESERT, CA 92211-1140
(760) 340-2682
(760) 773-9695
Mailing address
78120 WILDCAT DR, PALM DESERT, CA 92211-1140
(760) 340-2682
(760) 773-9695
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A166476
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/14/2017
Last updated
07/09/2020
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