Healthcare Provider Details

I. General information

NPI: 1326173949
Provider Name (Legal Business Name): ALIYAR A. PARVIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY OFFICE OF MEDICINE
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

29203 BEACHSIDE DR
PALOS VERDES ESTATES CA
90275-4901
US

V. Phone/Fax

Practice location:
  • Phone: 562-385-7611
  • Fax:
Mailing address:
  • Phone: 818-825-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number52214-020
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA125127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: