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General NPI Number Information
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NPI Number | 1750891727
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARDIOLOGY OF SAN DIEGO
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 5755 OBERLIN DR STE 202
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City | SAN DIEGO
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State | CA
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Zip | 92121-4716
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Country | US
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Telephone | 619-501-4015
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Fax | 619-501-2977
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Provider Business Mailing Address
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Address Line | 5755 OBERLIN DR STE 202
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City | SAN DIEGO
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State | CA
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Zip | 92121-4716
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Country | US
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Telephone | 619-501-4015
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Fax | 619-501-2977
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Authorized Official
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Title or Position | CEO
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Name | DR. DELARAM POUR MOLKARA
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Credential | MD
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Telephone | 619-501-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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