| Doctor Name: | OMID MODARRES MOUSAVI BEHBAHANI |
| NPI Number: | 1043444029 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A121076 |
| Business Practice Address: | 12130 Paramount Blvd Downey, CA - 902422339 |
| Business Phone Number: | 3238897830 |
| Business Fax Number: | |
| Mailing Address: | 11677 Goshen Ave, LOS ANGELES |
| State: | CA |
| Postal Code: | 900496252 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2009 |
| NPI Last Update Date: | 09/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QG0300X |
| License Number: | A121076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Geriatric Medicine |
| Taxonomy Definition: | A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |