Provider Demographics
NPI:1851650584
Name:MASHAYEKHI, PEGAH MARYAM (DO)
Entity type:Individual
Prefix:MS
First Name:PEGAH
Middle Name:MARYAM
Last Name:MASHAYEKHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12395 EL CAMINO REAL SUITE 209
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130
Mailing Address - Country:US
Mailing Address - Phone:858-224-1866
Mailing Address - Fax:858-207-5042
Practice Address - Street 1:12395 EL CAMINO REAL STE 209
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3084
Practice Address - Country:US
Practice Address - Phone:858-224-1866
Practice Address - Fax:858-207-5042
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A12987207RS0012X, 207R00000X, 207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ9433OtherTEXAS MEDICAL BOARD
CA20A12987OtherMEDICAL LICENSE