Healthcare Provider Details

I. General information

NPI: 1265694962
Provider Name (Legal Business Name): HOSSEIN EFTEKHARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 02/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8317 DAVIS ST STE A
DOWNEY CA
90241-4918
US

IV. Provider business mailing address

8317 DAVIS ST STE A
DOWNEY CA
90241-4918
US

V. Phone/Fax

Practice location:
  • Phone: 562-869-1511
  • Fax: 562-869-0771
Mailing address:
  • Phone: 562-869-1511
  • Fax: 562-869-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA103425
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number239909
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: