Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 0439448 | KS |
N | 207RH0002X | Hospice and Palliative Medicine | 30995 | OK |
NPI | 1376980078 |
---|---|
Provider Name | Dr. Ahmadreza Mirmiran |
First Address | Tarzana, CA 91356-4340 |
Second Address | Tarzana, CA 91356-4340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 02/02/2017 |