Individual
LALEH GHAFFARIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47111 MONROE ST, INDIO, CA 92201-6739
(760) 347-6191
Mailing address
6362 S CRESTMOUNT CIR, SALT LAKE CITY, UT 84121
(801) 657-9816
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A16775
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2016
Last updated
07/30/2020
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