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1407868789
VISTA S KHOSRAVI
SAN JOSE, CA
NPI
1407868789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207N00000X Dermatology
(Licence: CA G80120)
Enumeration Date
2006-08-13
Last Update Date
2007-07-08
Business Address
VISTA S KHOSRAVI M.D.
80 GREAT OAKS BLVD
SAN JOSE, CA 95119-1310
Phone number: 408-363-3000
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Mailing Address
VISTA S KHOSRAVI M.D.
1606 MONTELLANO CT
SAN JOSE, CA 95120-4833
Phone number: 408-927-9938
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