| Seaside Medical Practice | |
|
2319 Wilshire Blvd Santa Monica CA 90403-5801 | |
| (310) 393-5000 | |
| (310) 393-5007 |
| Full Name | Seaside Medical Practice |
|---|---|
| Speciality | Internal Medicine |
| Location | 2319 Wilshire Blvd, Santa Monica, California |
| Authorized Official Name and Position | Mahdi Yazdani (VP) |
| Authorized Official Contact | 3103935000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seaside Medical Practice 2319 Wilshire Blvd Santa Monica CA 90403-5801 Ph: (310) 393-5000 | Seaside Medical Practice 2319 Wilshire Blvd Santa Monica CA 90403-5801 Ph: (310) 393-5000 |
| NPI Number | 1528203999 |
|---|---|
| Provider Enumeration Date | 12/12/2008 |
| Last Update Date | 04/10/2022 |
| Medicare PECOS PAC ID | 3971651142 |
|---|---|
| Medicare Enrollment ID | O20090427000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528203999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A90937 (California) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | A90937 (California) | Primary |
| Provider Name | Nasimeh Yazdani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154376580 PECOS PAC ID: 4688679244 Enrollment ID: I20061003000629 |
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