MEDICARE: DR. KAMRON IZADI MD

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	2085R0202X	Diagnostic Radiology Physician	EMC0005154	MI
2	2085R0202X	Diagnostic Radiology Physician	A102215	CA

General Provider Information

NPI Number	:	1871757005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMRON IZADI MD

Provider Business Mailing Address
First Line	:	46E PENINSULA CTR # 226
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	46E PENINSULA CTR # 226
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:	657-224-2430
Fax Number	:

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	12/26/2024

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