Organization
RAY DERAKSHAN, DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY DERAKSHAN DMD INC. (DENTIST)
(858) 485-1010
Entity
Organization
Contact information
Practice address
11134 RANCHO CARMEL DR. #103, SAN DIEGO, CA 92128
(858) 485-1010
(858) 485-1116
Mailing address
11134 RANCHO CARMEL DR. #103, SAN DIEGO, CA 92128
(858) 485-1010
(858) 485-1116
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
46044
CA
Other
Enumeration date
01/21/2009
Last updated
10/22/2021
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