Individual
DIBA MORTAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
930 CHESTNUT RIDGE RD, MORGANTOWN, WV 26505-2807
(304) 293-5323
(304) 293-8724
Mailing address
10380 SPRING CANYON RD UNIT 442, SAN DIEGO, CA 92131-3877
(916) 458-2324
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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