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NPI Code Detail

MEDICARE: ANAHITA DEYLAMSALEHI MD

MEDICARE: ANAHITA DEYLAMSALEHI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCT
2207R00000XInternal Medicine PhysicianMD.MD.70063572WA

General Provider Information

NPI Number : 1376246868
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANAHITA DEYLAMSALEHI MD
Provider Business Mailing Address
First Line : 360 S MARKET ST UNIT 1704
Second Line :
City : SAN JOSE
State : CA
Zip : 95113-2872
Country : US
Telephone Number : 415-815-5445
Fax Number :
Provider Business Practice Location Address
First Line : 1615 DELAWARE ST
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2367
Country : US
Telephone Number : 360-501-3601
Fax Number : 360-501-3648
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 05/13/2026

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Directions to “ ANAHITA DEYLAMSALEHI MD” Practice Location

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