Individual
BAHARAK FOROUZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15611 POMERADO RD STE 525, POWAY, CA 92064-2439
(858) 485-5301
Mailing address
17730 VALLE VERDE RD, POWAY, CA 92064-1002
(858) 373-7126
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA52147
CA
Other
Enumeration date
11/12/2015
Last updated
02/05/2016
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