Individual
LILLIE AKRAM MOSADDEGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
380 W PORTAL AVE, STE B, SAN FRANCISCO, CA 94127-1428
(415) 285-3895
(410) 392-8622
Mailing address
380 W PORTAL AVE STE B, SAN FRANCISCO, CA 94127-1428
(415) 285-3895
(410) 392-8622
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G79847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G798470
BLUE SHIELD
—
05
—
00G798470
—
CA
Enumeration date
12/05/2006
Last updated
10/17/2011
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