Individual
AHMAD SHAHROKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 N ANAHEIM BLVD, ANAHEIM, CA 92805-2651
(714) 776-7490
Mailing address
710 N ANAHEIM BLVD, ANAHEIM, CA 92805-2651
(714) 776-7490
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1516980823
CA
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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