Provider Demographics
NPI:1366457293
Name:TEHRANCHI, FATIMA (MD)
Entity type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:TEHRANCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-2007
Mailing Address - Country:US
Mailing Address - Phone:415-706-8962
Mailing Address - Fax:
Practice Address - Street 1:37 IRVING AVE
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-2007
Practice Address - Country:US
Practice Address - Phone:650-324-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2015-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA038233207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ16205ZMedicare ID - Type Unspecified
A28572Medicare UPIN