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Individual

DR. BEHZAD BANIADAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3231 WARING CT STE L, OCEANSIDE, CA 92056-4510
(760) 630-6300
(760) 630-1100
Mailing address
1618 BURGUNDY RD, ENCINITAS, CA 92024-1207
(760) 630-6300
(760) 630-1100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A055698
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D1022589
CLIA
CA
Enumeration date
07/13/2006
Last updated
03/07/2023
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