| Pouya Shafipour Md Inc | |
|
1950 Sawtelle Blvd Ste 130 Los Angeles CA 90025-7072 | |
| (310) 996-9355 | |
| (310) 494-0061 |
| Full Name | Pouya Shafipour Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1950 Sawtelle Blvd Ste 130, Los Angeles, California |
| Authorized Official Name and Position | Pouya Shafipour (INCORPORATOR) |
| Authorized Official Contact | 3109969355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pouya Shafipour Md Inc 1950 Sawtelle Blvd Ste 130 Los Angeles CA 90025-7072 Ph: (310) 996-9355 | Pouya Shafipour Md Inc 1950 Sawtelle Blvd Ste 130 Los Angeles CA 90025-7072 Ph: (310) 996-9355 |
| NPI Number | 1316177280 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 03/16/2010 |
| Medicare PECOS PAC ID | 4880733468 |
|---|---|
| Medicare Enrollment ID | O20091120000622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316177280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Pouya Shafipour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952426454 PECOS PAC ID: 0345332565 Enrollment ID: I20070817000322 |
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