Healthcare Provider Details

I. General information

NPI: 1750437752
Provider Name (Legal Business Name): SAID T DANESHMAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11425 EL CAMINO REAL
SAN DIEGO CA
92130
US

IV. Provider business mailing address

11425 EL CAMINO REAL
SAN DIEGO CA
92130
US

V. Phone/Fax

Practice location:
  • Phone: 858-794-6363
  • Fax: 858-794-6360
Mailing address:
  • Phone: 858-794-6363
  • Fax: 858-794-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberG79968
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: