Provider Demographics
NPI:1871916841
Name:MEHRYAN, TOUFAN RODNEY (MD)
Entity type:Individual
Prefix:DR
First Name:TOUFAN
Middle Name:RODNEY
Last Name:MEHRYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7955 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4001
Mailing Address - Country:US
Mailing Address - Phone:714-379-3221
Mailing Address - Fax:714-379-3211
Practice Address - Street 1:7955 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4001
Practice Address - Country:US
Practice Address - Phone:714-379-3221
Practice Address - Fax:714-379-3211
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128452208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice