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Individual

MANI EHTESHAMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
27 CLERMONT, NEWPORT BEACH, CA 92657-1069
(949) 706-2796
(949) 706-2072
Mailing address
27 CLERMONT, NEWPORT BEACH, CA 92657-1069
(949) 706-2796
(949) 706-2072

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G74263
CA
207ZP0101X
Anatomic Pathology Physician
Primary
G74263
CA

Other

Enumeration date
03/15/2006
Last updated
11/01/2011
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