Ira J Golchehreh, LAC OMD QME

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC003592 Issued in CA

Practice address

2175D E Francisco Blvd
San Rafael, CA 94901

Phone

(415) 485-4411

Fax

(415) 485-0857

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Iraj Golchehreh Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760515407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175D E FRANCISCO BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-485-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175D E FRANCISCO BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-485-4411",
            "fax_number": "415-485-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLCHEHREH",
        "first_name": "IRA",
        "middle_name": "J",
        "credential": "LAC OMD QME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC003592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE BOARD OF CA",
            "identifier": "AC003592",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRAJ",
            "last_name": "GOLCHEHREH",
            "credential": "LAC OMD QME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joanna Gobea, FNP
• Stephen Courtney Godfrey, O.D.
• Elizabeth Ayon Godinez
• Adrianne Goff, CCN, M.H.
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• Albert Chester Goldberg, MD
• William Goldberg, LPCC
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• Ronald Golden, RONALD GOLDEN, L.AC.

• Acupuncturist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.