Healthcare Provider Details

I. General information

NPI: 1245256650
Provider Name (Legal Business Name): MEHMET C DEMIROZU M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4477 W 118TH ST SUITE 303
HAWTHORNE CA
90250-2255
US

IV. Provider business mailing address

PO BOX 641245
LOS ANGELES CA
90064-6245
US

V. Phone/Fax

Practice location:
  • Phone: 310-644-9515
  • Fax: 310-644-3629
Mailing address:
  • Phone: 310-644-9515
  • Fax: 310-644-3629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA52940
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA52940
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA52940
License Number StateCA

VIII. Authorized Official

Name: DR. MEHMET C DEMIROZU
Title or Position: PULMONALOGIST
Credential: M.D.
Phone: 310-644-9515