Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bahram Derakhshan

Individual provider Physical Therapy Assistant · NPI 1124779681

Bahram Derakhshan is a Physical Therapy Assistant in Poway, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022
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Practice location Address checks out

14015 Frame Rd
Poway, CA 92064-3205
Phone: (858) 774-6241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 4079 (CA)

Record details

NPI number1124779681
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 15, 2022
Last updated in NPPESJanuary 15, 2022
Certification dateJanuary 15, 2022
Mailing address14015 Frame Rd, Poway, CA 92064-3205

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