Individual
MANSOOR MOVAGHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 FROST ST STE 200, SAN DIEGO, CA 92123
(858) 309-7702
Mailing address
3020 CHILDRENS WAY # MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A100897
CA
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
A100897
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32577200
—
WI
01
—
9270
DEAN HEATLH INSURANCE
WI
Enumeration date
06/01/2006
Last updated
04/20/2020
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