Individual
DR. MOHAMMADREZA GHAYURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3470
(909) 580-3289
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3470
(909) 580-3289
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35.090050
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
C54829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073711156
—
CA
Enumeration date
07/10/2007
Last updated
02/27/2018
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