| Mehdi Khorsandi Md Inc. | |
|
1510 S Central Ave 620 Glendale CA 91204-2500 | |
| (818) 500-1676 | |
| (818) 500-8360 |
| Full Name | Mehdi Khorsandi Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1510 S Central Ave, Glendale, California |
| Authorized Official Name and Position | Mehdi Khorsandi (OWNER) |
| Authorized Official Contact | 8185001676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mehdi Khorsandi Md Inc. 1510 S Central Ave 620 Glendale CA 91204-2500 Ph: (818) 500-1676 | Mehdi Khorsandi Md Inc. 1510 S Central Ave 620 Glendale CA 91204-2500 Ph: (818) 500-1676 |
| NPI Number | 1215962063 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 09/14/2018 |
| Medicare PECOS PAC ID | 3577650019 |
|---|---|
| Medicare Enrollment ID | O20071031000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215962063 | NPI | - | NPPES |
| 00A528020 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A52802 (California) | Primary |
| Provider Name | Mehdi Khorsandi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588607691 PECOS PAC ID: 5597734475 Enrollment ID: I20040928000442 |
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