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General NPI Number Information
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NPI Number | 1851650584
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Entity Type | Individual
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Provider Name | PEGAH MARYAM MASHAYEKHI D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 12395 EL CAMINO REAL STE 209
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City | SAN DIEGO
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State | CA
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Zip | 92130-3084
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Country | US
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Telephone | 858-224-1866
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Fax | 858-207-5042
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Provider Business Mailing Address
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Address Line | 12395 EL CAMINO REAL SUITE 209
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City | SAN DIEGO
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State | CA
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Zip | 92130
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Country | US
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Telephone | 858-224-1866
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Fax | 858-207-5042
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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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 20A12987
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A12987
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number | 20A12987
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License Number State | CA
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