NPI 1255579793

Ray Derakshan, DMD INC

Organisation Preferred Provider Organization San Diego, CA

Practice location

Address: 11134 Rancho Carmel Dr. #103, San Diego, CA 92128
Phone: (858) 485-1010
Fax: (858) 485-1116

Authorised official

Name: Ray Derakshan
Title: Dentist
Phone: (858) 485-1010

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 46044 (CA)

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Registry record

NPI: 1255579793
Entity type: Organization
NPI issued: 21 Jan 2009
Record last updated: 22 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.