| Amin Khorsandi Md Inc | |
|
2222 Santa Monica Blvd # 301 Santa Monica CA 90404-2304 | |
| (310) 449-0093 | |
| (310) 449-9204 |
| Full Name | Amin Khorsandi Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2222 Santa Monica Blvd, Santa Monica, California |
| Authorized Official Name and Position | Amin Khorsandi (PRESIDENT) |
| Authorized Official Contact | 3104490093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amin Khorsandi Md Inc 2222 Santa Monica Blvd # 301 Santa Monica CA 90404-2304 Ph: (310) 449-0093 | Amin Khorsandi Md Inc 2222 Santa Monica Blvd # 301 Santa Monica CA 90404-2304 Ph: (310) 449-0093 |
| NPI Number | 1841511631 |
|---|---|
| Provider Enumeration Date | 06/16/2010 |
| Last Update Date | 08/06/2015 |
| Medicare PECOS PAC ID | 4385774389 |
|---|---|
| Medicare Enrollment ID | O20100618000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841511631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A56357 (California) | Primary |
| Provider Name | Amin Khorsandi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275547390 PECOS PAC ID: 6800969957 Enrollment ID: I20090813000348 |
| Provider Name | Tammy Ung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699434183 PECOS PAC ID: 6608246012 Enrollment ID: I20221229001897 |
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