Provider Demographics
NPI:1306074893
Name:POUR MOLKARA, DELARAM (MD)
Entity type:Individual
Prefix:
First Name:DELARAM
Middle Name:
Last Name:POUR MOLKARA
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 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4800
Mailing Address - Country:US
Mailing Address - Phone:858-309-6290
Mailing Address - Fax:858-309-6301
Practice Address - Street 1:2333 CAMINO DEL RIO S STE 340
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3615
Practice Address - Country:US
Practice Address - Phone:619-501-4015
Practice Address - Fax:619-501-2977
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94309208000000X
CAA940392080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics