| Kamran Broukhim, Md, Pc | |
|
19228 Ventura Blvd Unit D Tarzana CA 91356-3101 | |
| (818) 875-0750 | |
| (818) 578-8616 |
| Full Name | Kamran Broukhim, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 19228 Ventura Blvd Unit D, Tarzana, California |
| Authorized Official Name and Position | Kamran Broukhim (PRESIDENT, MEDICAL DIRECTOR) |
| Authorized Official Contact | 8186933655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kamran Broukhim, Md, Pc 19228 Ventura Blvd Unit D Tarzana CA 91356-3101 Ph: (818) 875-0750 | Kamran Broukhim, Md, Pc 19228 Ventura Blvd Unit D Tarzana CA 91356-3101 Ph: (818) 875-0750 |
| NPI Number | 1871235085 |
|---|---|
| Provider Enumeration Date | 04/08/2022 |
| Last Update Date | 04/08/2022 |
| Medicare PECOS PAC ID | 6103203708 |
|---|---|
| Medicare Enrollment ID | O20220520001346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871235085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kamran Broukhim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619060456 PECOS PAC ID: 3375434939 Enrollment ID: I20080321000184 |
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