Individual
ABOLGHASEM DARVISHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2410 DYER LN, FREMONT, CA 94536-5322
(510) 505-9409
Mailing address
347 AUBURN WAY APT 1, SAN JOSE, CA 95129-1647
(408) 966-8897
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
110478
CA
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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