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NPI Code Detail

MEDICARE: SYRUS FERIDOUNI M.D.

MEDICARE: SYRUS FERIDOUNI M.D.
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
1207Q00000XFamily Medicine PhysicianA97912CA
2207QA0505XAdult Medicine PhysicianA97912CA

General Provider Information

NPI Number : 1336271055
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYRUS FERIDOUNI M.D.
Provider Business Mailing Address
First Line : 801 S CHEVY CHASE DR STE 250
Second Line :
City : GLENDALE
State : CA
Zip : 91205-4433
Country : US
Telephone Number : 818-265-2264
Fax Number : 818-265-2263
Provider Business Practice Location Address
First Line : 801 S CHEVY CHASE DR STE 250
Second Line :
City : GLENDALE
State : CA
Zip : 91205-4433
Country : US
Telephone Number : 818-265-2264
Fax Number : 818-265-2263
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/11/2007

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Directions to “ SYRUS FERIDOUNI M.D.” Practice Location

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