Organization Name: | BEHROUZ DARDASHTI M.D.INC. |
NPI Number: | 1780055269 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BEHROUZ DARDASHTI (PRESIDENT) |
Mailing Address: | 16250 Ventura Blvd Suite 230 Encino |
State: | CA US |
Postal Code: | 914362204 |
Phone Number: | 8189956003 |
Fax Number: | 8189953862 |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A38320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |