Healthcare Provider Details

I. General information

NPI: 1932499332
Provider Name (Legal Business Name): SOHRAB PAHLAVAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 HOSPITAL PKWY FL 3
SAN JOSE CA
95119-1106
US

IV. Provider business mailing address

275 HOSPITAL PKWY FL 3
SAN JOSE CA
95119-1106
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-6100
  • Fax:
Mailing address:
  • Phone: 408-363-4896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA121930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: