Healthcare Provider Details

I. General information

NPI: 1366457293
Provider Name (Legal Business Name): FATIMA TEHRANCHI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 12/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 IRVING AVE
ATHERTON CA
94027-2007
US

IV. Provider business mailing address

37 IRVING AVE
ATHERTON CA
94027-2007
US

V. Phone/Fax

Practice location:
  • Phone: 650-324-2499
  • Fax:
Mailing address:
  • Phone: 415-706-8962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA038233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: