Doctor Name: | MR. IRA IRADJ POURATIAN |
NPI Number: | 1548407703 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | CA A032128 |
Business Practice Address: | 325 No. Oakhurst Drive #503 Beverly Hills, CA - 902104149 |
Business Phone Number: | 2133939980 |
Business Fax Number: | 3108586656 |
Mailing Address: | 325 No. Oakhurst Drive, #503 BEVERLY HILLS |
State: | CA |
Postal Code: | 902104149 |
Phone Number: | 2133939980 |
Fax Number: | 3108586656 |
NPI Enumeration Date: | 01/09/2009 |
NPI Last Update Date: | 01/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | CA A032128 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |