Individual
IRA J GOLCHEHREH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC OMD QME
Contact information
Practice address
2175D E FRANCISCO BLVD, SAN RAFAEL, CA 94901
(415) 485-4411
(415) 485-0857
Mailing address
2175D E FRANCISCO BLVD, SAN RAFAEL, CA 94901
(415) 485-4411
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC003592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC003592
ACUPUNCTURE BOARD OF CA
CA
Enumeration date
03/13/2007
Last updated
07/08/2007
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