Healthcare Provider Details

I. General information

NPI: 1598865388
Provider Name (Legal Business Name): NARSIS GOLKARIEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 N GAREY AVE
POMONA CA
91767-2720
US

IV. Provider business mailing address

1920 N GAREY AVE
POMONA CA
91767-2720
US

V. Phone/Fax

Practice location:
  • Phone: 909-622-1235
  • Fax: 909-622-1960
Mailing address:
  • Phone: 909-622-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA88808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: