MEDICARE: SIAMAK TEHRANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH68798	CA

General Provider Information

NPI Number	:	1164942769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIAMAK TEHRANI

Provider Business Mailing Address
First Line	:	10538 EASTBORNE AVE #204
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024
Country	:	US
Telephone Number	:	310-773-2226
Fax Number	:

Provider Business Practice Location Address
First Line	:	6007 LANKERSHIM BLVD STE 7
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-4883
Country	:	US
Telephone Number	:	818-763-7007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2017
Last Update Date	:	06/23/2017

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Directions to “ SIAMAK TEHRANI ” Practice Location

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