Individual provider · NPI-1

Kauroon Mazdak Darya, D.O

Psychiatry & Neurology, Neurology · Roseville, CA

NPI number1922414796
StatusActive
Last updated in NPPESNov 18, 2020

Details

NPI
1922414796
Entity type
Individual (NPI-1)
Name
Kauroon Mazdak Darya
Credential
D.O
Sex
Male
Sole proprietor
No
Enumeration date
Jul 1, 2014
Certification date
Oct 26, 2020
Last updated
Nov 18, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology20A16208CAYes
2084N0400X Psychiatry & Neurology, NeurologyOS15149FL

Practice location

729 Sunrise Ave Ste 616
Roseville, CA 95661-4548

Phone 954-732-1211 · Fax 530-852-3607

Mailing address

729 Sunrise Ave Ste 616
Roseville, CA 95661-4548

Phone 954-732-1211 · Fax 530-852-3607

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