| Bagheri Medical Group | |
|
75 Parnassus Rd Berkeley CA 94708-2056 | |
| (805) 781-9111 | |
| (805) 285-4055 |
| Full Name | Bagheri Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 75 Parnassus Rd, Berkeley, California |
| Authorized Official Name and Position | Kourosh Darren Bagheri (MD/OWNER) |
| Authorized Official Contact | 8057819111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bagheri Medical Group 75 Parnassus Rd Berkeley CA 94708-2056 Ph: (805) 781-9111 | Bagheri Medical Group 75 Parnassus Rd Berkeley CA 94708-2056 Ph: (805) 781-9111 |
| NPI Number | 1740367275 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/10/2023 |
| Medicare PECOS PAC ID | 0547259723 |
|---|---|
| Medicare Enrollment ID | O20040511001769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740367275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | G77496 (California) | Primary |
| Provider Name | Kourosh Bagheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457540031 PECOS PAC ID: 5799774972 Enrollment ID: I20040512000789 |
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