| Shahla Kohanzadeh Md Medical Corporation | |
|
803 S Alvarado St Los Angeles CA 90057-4009 | |
| (213) 381-1117 | |
| (213) 381-5903 |
| Full Name | Shahla Kohanzadeh Md Medical Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 803 S Alvarado St, Los Angeles, California |
| Authorized Official Name and Position | Shahla Kohanzadeh (CEO) |
| Authorized Official Contact | 2133811117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahla Kohanzadeh Md Medical Corporation 803 S Alvarado St Los Angeles CA 90057-4009 Ph: (213) 381-1117 | Shahla Kohanzadeh Md Medical Corporation 803 S Alvarado St Los Angeles CA 90057-4009 Ph: (213) 381-1117 |
| NPI Number | 1891086716 |
|---|---|
| Provider Enumeration Date | 04/26/2011 |
| Last Update Date | 07/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891086716 | NPI | - | NPPES |
| A479640 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A47964 (California) | Primary |
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