Individual
NEEMA POURTAHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
(707) 546-1922
(707) 546-1897
Mailing address
1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
(707) 546-1922
(707) 546-1897
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A145410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A145410
LICENSE
CA
Enumeration date
08/28/2007
Last updated
01/19/2017
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