| Doctor Name: | DR. MAX MAHMOUD GHANNADI |
| NPI Number: | 1114191798 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., |
| License Number: | A102618 |
| Business Practice Address: | 14103 Victory Blvd Suite 7 Van Nuys, CA - 913043863 |
| Business Phone Number: | 8189940000 |
| Business Fax Number: | 8189882949 |
| Mailing Address: | 23679 Calabasas Rd # 327, CALABASAS |
| State: | CA |
| Postal Code: | 913021502 |
| Phone Number: | 8188875515 |
| Fax Number: | 8182259230 |
| NPI Enumeration Date: | 04/15/2008 |
| NPI Last Update Date: | 10/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A102618 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |