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General NPI Number Information
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NPI Number | 1407316136
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Entity Type | Individual
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Provider Name | MOHAMMAD-ALI DOROUDCHI
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVE STE 710
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City | LA JOLLA
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State | CA
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Zip | 92037-1218
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Country | US
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Telephone | 858-260-2977
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Fax |
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Provider Business Mailing Address
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Address Line | 9850 GENESEE AVE STE 710
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City | LA JOLLA
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State | CA
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Zip | 92037-1218
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Country | US
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Telephone | 858-260-2977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A177620
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License Number State | CA
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