| Mohsen Kheradpezhouh Md, Inc | |
|
10465 Eastborne Ave Apt 306 Los Angeles CA 90024-6181 | |
| (818) 248-0364 | |
| (818) 247-1330 |
| Full Name | Mohsen Kheradpezhouh Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10465 Eastborne Ave, Los Angeles, California |
| Authorized Official Name and Position | Mohsen Kheradpezhouh (PRESIDENT) |
| Authorized Official Contact | 8182480364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohsen Kheradpezhouh Md, Inc 10465 Eastborne Ave Apt 306 Los Angeles CA 90024-6181 Ph: (818) 248-0364 | Mohsen Kheradpezhouh Md, Inc 10465 Eastborne Ave Apt 306 Los Angeles CA 90024-6181 Ph: (818) 248-0364 |
| NPI Number | 1861815771 |
|---|---|
| Provider Enumeration Date | 01/28/2014 |
| Last Update Date | 02/05/2014 |
| Medicare PECOS PAC ID | 5395964373 |
|---|---|
| Medicare Enrollment ID | O20140924001863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861815771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A99424 (California) | Primary |
| Provider Name | Mohsen Kheradpezhouh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346363405 PECOS PAC ID: 4082783436 Enrollment ID: I20080527000473 |
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