Individual
NEDA TAHAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
30448 RANCHO VIEJO RD STE 150, SAN JUAN CAPISTRANO, CA 92675-1572
(949) 677-7704
Mailing address
905 CALLE AMANECER STE 115, SAN CLEMENTE, CA 92673-6226
(949) 677-7704
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
59896
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2020
Last updated
11/01/2022
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