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General NPI Number Information
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NPI Number | 1962433771
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Entity Type | Individual
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Provider Name | FRAIDOON MOSTAMAND DO
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 200 W ARBOR DR
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone | 619-543-6222
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Fax |
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Provider Business Mailing Address
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Address Line | FILE NO 54826
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City | LOS ANGELES
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State | CA
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Zip | 90074-4826
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Country | US
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Telephone | 888-486-4340
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO-120
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A7026
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License Number State | CA
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