| Edgar Mehdikhani Md Inc. | |
|
222 W Eulalia St Ste 114 Glendale CA 91204-2851 | |
| (818) 242-8916 | |
| (818) 241-7708 |
| Full Name | Edgar Mehdikhani Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 222 W Eulalia St Ste 114, Glendale, California |
| Authorized Official Name and Position | Edgar Mehdikhani (PRESIDENT) |
| Authorized Official Contact | 3109278905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgar Mehdikhani Md Inc. 222 W Eulalia St Ste 114 Glendale CA 91204-2851 Ph: (818) 242-8916 | Edgar Mehdikhani Md Inc. 222 W Eulalia St Ste 114 Glendale CA 91204-2851 Ph: (818) 242-8916 |
| NPI Number | 1063789774 |
|---|---|
| Provider Enumeration Date | 11/23/2011 |
| Last Update Date | 09/05/2019 |
| Medicare PECOS PAC ID | 7618131996 |
|---|---|
| Medicare Enrollment ID | O20120618000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063789774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A96024 (California) | Primary |
| Provider Name | Edgar Mehdikhani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962680348 PECOS PAC ID: 1254523582 Enrollment ID: I20101005001136 |
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