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SHALA RAHBAR FARDIN MD

>> Dermatology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1720114432

Individual Registrant:
 SHALA RAHBAR FARDIN MD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2330 MARINSHIP WAY STE 370  SAUSALITO, CA 94965-2853 US
Tel: 415-887-9758  Fax: 415-887-9763

Contact information for business:
2330 MARINSHIP WAY STE 370  SAUSALITO, CA 94965-2853 US
Tel: 415-887-9758  Fax: 415-887-9763

Registration Information:
NPI: 1720114432
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207N00000XAllopathic & Osteopathic Physicians
Dermatology
MAP-230971
Y207N00000XAllopathic & Osteopathic Physicians
Dermatology
CAA98841

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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