| Maryam Seddigh Tonekaboni, Md, Inc. | |
|
18350 Roscoe Blvd Ste 307 Northridge CA 91325-4159 | |
| (818) 671-1989 | |
| (818) 698-0440 |
| Full Name | Maryam Seddigh Tonekaboni, Md, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 18350 Roscoe Blvd Ste 307, Northridge, California |
| Authorized Official Name and Position | Maryam Seddigh Tonekaboni (PRESIDENT) |
| Authorized Official Contact | 8182744358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryam Seddigh Tonekaboni, Md, Inc. 18350 Roscoe Blvd Ste 307 Northridge CA 91325-4159 Ph: (818) 671-1989 | Maryam Seddigh Tonekaboni, Md, Inc. 18350 Roscoe Blvd Ste 307 Northridge CA 91325-4159 Ph: (818) 671-1989 |
| NPI Number | 1689120586 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 02/02/2017 |
| Medicare PECOS PAC ID | 7416236484 |
|---|---|
| Medicare Enrollment ID | O20161115000643 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689120586 | NPI | - | NPPES |
| 1851663744 | Other | CA | INDIVIDUAL NPI |
| 1689120586 | Other | CA | NPI GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A118665 (California) | Primary |
| Provider Name | Maryam Seddigh Tonekaboni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851663744 PECOS PAC ID: 8426294968 Enrollment ID: I20130429000369 |
| Provider Name | Amir Kashefi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1558591933 PECOS PAC ID: 9537474119 Enrollment ID: I20180427000546 |
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