Individual
DR. BAHRAM KHADIVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
402 DICKINSON ST, MULTIPURPOSE FACILITY, SUITE 380, SAN DIEGO, CA 92103-6902
(619) 543-6268
Mailing address
402 DICKINSON ST, MULTIPURPOSE FACILITY, SUITE 380, SAN DIEGO, CA 92103-6902
(619) 543-6268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A100290
CA
Other
Enumeration date
01/04/2008
Last updated
12/06/2021
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