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NPI Code Detail

MEDICARE: HOOMAN MEHDI JAVANMARDI

MEDICARE:   HOOMAN MEHDI JAVANMARDI
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
1225100000XPhysical Therapist26950CA

General Provider Information

NPI Number : 1679890339
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOOMAN MEHDI JAVANMARDI
Provider Business Mailing Address
First Line : 3427 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3254
Country : US
Telephone Number : 951-684-2865
Fax Number :
Provider Business Practice Location Address
First Line : 3427 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3254
Country : US
Telephone Number : 951-684-2865
Fax Number : 951-934-0555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2010
Last Update Date : 02/20/2012

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Directions to “ HOOMAN MEHDI JAVANMARDI ” Practice Location

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