Provider Demographics
NPI:1578671905
Name:VAGHAR, FOROUZAN (MD)
Entity type:Individual
Prefix:DR
First Name:FOROUZAN
Middle Name:
Last Name:VAGHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 LOS GATOS SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5317
Mailing Address - Country:US
Mailing Address - Phone:408-354-3587
Mailing Address - Fax:408-354-3651
Practice Address - Street 1:248 LOS GATOS SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5317
Practice Address - Country:US
Practice Address - Phone:408-354-3587
Practice Address - Fax:408-354-3651
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA063086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine