Individual provider · Type 1 NPI

Ida Ghlichloo, MD

Student in an Organized Health Care Education/Training Program · La Jolla, CA

NPI number 1124529797 Active · reactivated Oct 20, 2022

Practice location

9500 Gilman Dr
La Jolla, CA 92093-1653

Call (650) 271-9445 Map

Mailing address

472 Biscayne Ave
Foster City, CA 94404-3550

Other practice locations

  • 424 Peninsula Ave, San Mateo, CA 94401-1653 · (650) 286-4396

Specialties and licenses

TaxonomyCodeLicense
Assistant Behavior Analyst 106E00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1124529797

Ida Ghlichloo, MD's National Provider Identifier is 1124529797, issued on Feb 28, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in La Jolla, CA. The record was last updated on Oct 30, 2022.