Individual
DR. SOROSCH DIDEHVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 782-3710
Mailing address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 683-6370
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A141506
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A141506
CA
Other
Enumeration date
06/11/2012
Last updated
02/24/2020
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