Individual
BAHRAM DERAKHSHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14015 FRAME RD, POWAY, CA 92064-3205
(858) 774-6241
Mailing address
14015 FRAME RD, POWAY, CA 92064-3205
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4079
CA
Other
Enumeration date
01/15/2022
Last updated
01/15/2022
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