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Organization

HOUMAN DAHI M.D., APC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANYA WALLACE (MEDICAL BILLER)
(619) 299-2570
Entity
Organization

Contact information

Practice address
501 WASHINGTON ST, SUITE 508, SAN DIEGO, CA 92103-2231
(619) 299-2570
(619) 294-2738
Mailing address
501 WASHINGTON ST, SUITE 508, SAN DIEGO, CA 92103-2231
(619) 299-2570
(619) 294-2738

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A98386
CA
207RP1001X
Pulmonary Disease Physician
Primary
A98386
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A98386
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11175012
CAQH
CA
01
A98386
CA MEDICAL LICENSE
CA
Enumeration date
08/05/2009
Last updated
02/04/2015
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