| A Shawn Veiseh Md A Professional Corporation Executive Physical Progra | |
|
100 Ucla Medical Plz Suite 720 Los Angeles CA 90024-6970 | |
| (310) 208-0708 | |
| (310) 209-1577 |
| Full Name | A Shawn Veiseh Md A Professional Corporation Executive Physical Progra |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Ucla Medical Plz, Los Angeles, California |
| Authorized Official Name and Position | Afshin Shawn Vieseh (PRESIDENT) |
| Authorized Official Contact | 3102080708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Shawn Veiseh Md A Professional Corporation Executive Physical Progra 100 Ucla Medical Plz Suite 720 Los Angeles CA 90024-6970 Ph: (310) 208-0708 | A Shawn Veiseh Md A Professional Corporation Executive Physical Progra 100 Ucla Medical Plz Suite 720 Los Angeles CA 90024-6970 Ph: (310) 208-0708 |
| NPI Number | 1285737353 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 04/18/2012 |
| Medicare PECOS PAC ID | 1951562958 |
|---|---|
| Medicare Enrollment ID | O20120419000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285737353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G74878 (California) | Primary |
| Provider Name | Afshin Shawn Veiseh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205807146 PECOS PAC ID: 0840451845 Enrollment ID: I20120419000116 |
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