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Individual

MAHNAZ ENTEZARALMAHDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10565 CIVIC CENTER DR BLDG SUITE165, RANCHO CUCAMONGA, CA 91730-3853
(909) 985-2211
(909) 985-2244
Mailing address
10565 CIVIC CENTER DR BLDG SUITE165, RANCHO CUCAMONGA, CA 91730-3853
(909) 985-2211
(909) 985-2244

Taxonomy

Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
A147204
CA
390200000X
Student in an Organized Health Care Education/Training Program
TX

Other

Enumeration date
05/16/2014
Last updated
05/28/2019
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