Individual
BAHRAM MARZBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
22482 RIPPLING BRK, LAKE FOREST, CA 92630-5625
(949) 350-3661
Mailing address
22482 RIPPLING BRK, LAKE FOREST, CA 92630-5625
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY27191
CA
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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