Individual
DR. MOHAMMAD EGHTEDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
44678
TX
2085R0202X
Diagnostic Radiology Physician
Primary
A114372
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338818301
—
TX
01
—
8ER506
BCBS
TX
Enumeration date
04/26/2012
Last updated
02/19/2019
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