Individual
DR. MAHINDOKHT MARY RAISZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5222 BALBOA AVE, STE 45, SAN DIEGO, CA 92117-6904
(858) 616-6430
Mailing address
5222 BALBOA AVE, STE 45, SAN DIEGO, CA 92117-6904
(858) 616-6430
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A34656
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A346561
—
CA
Enumeration date
11/16/2006
Last updated
11/05/2012
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