Provider Demographics
NPI:1346540903
Name:DEHKORDI, ROSHANAK K (MD)
Entity type:Individual
Prefix:DR
First Name:ROSHANAK
Middle Name:K
Last Name:DEHKORDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSHANAK
Other - Middle Name:K
Other - Last Name:BAHREMAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1427
Mailing Address - Country:US
Mailing Address - Phone:818-720-2405
Mailing Address - Fax:
Practice Address - Street 1:1000 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-1704
Practice Address - Country:US
Practice Address - Phone:818-720-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program