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Individual

DR. BAHMAN JALALI NOURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2900 WHIPPLE AVE STE 230, REDWOOD CITY, CA 94062
(650) 306-2300
(650) 306-2345
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A69321
CA
207RC0000X
Cardiovascular Disease Physician
A69321
CA
207RI0011X
Interventional Cardiology Physician
Primary
A69321
CA

Other

Enumeration date
07/28/2006
Last updated
08/27/2018
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