Healthcare Provider Details

I. General information

NPI: 1114183993
Provider Name (Legal Business Name): ALI GOLSHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR STE 306
BEVERLY HILLS CA
90210-4309
US

IV. Provider business mailing address

9450 SW GEMINI DR PMB 891361
BEAVERTON OR
97008-7105
US

V. Phone/Fax

Practice location:
  • Phone: 310-974-8767
  • Fax: 310-496-2722
Mailing address:
  • Phone: 310-974-8767
  • Fax: 310-496-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA108102
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA108102
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: