Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 20A11899 | CA |
NPI | 1003132523 |
---|---|
Provider Name | Dr. Ardavan Mashhadian |
First Address | Los Angeles, CA 90015-3069 |
Second Address | Los Angeles, CA 90015-3069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 15/05/2019 |