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Individual

DR. AZITA CHEHRESA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1220 ROSSMOOR PKWY, WALNUT CREEK, CA 94595-2501
(925) 939-1220
Mailing address
DEPT 34929, P.O. BOX 39000, SAN FRANCISCO, CA 94139-0001
(925) 952-2828
(925) 952-2850

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01064679A
IN
207Q00000X
Family Medicine Physician
Primary
C134739
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200947090
IN
01
P01157324
RR MEDICARE PTAN
IN
Enumeration date
07/03/2008
Last updated
02/08/2016
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