Individual
GHOLAMHOSSEI PEZESHKPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 N TUSTIN AVE, SANTA ANA, CA 92705-3502
(714) 835-3555
(714) 953-3541
Mailing address
1001 N TUSTIN AVE, SANTA ANA, CA 92705-3502
(714) 835-3555
(714) 953-3541
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C42944
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C429440
—
CA
Enumeration date
01/08/2007
Last updated
08/05/2016
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