Healthcare Provider Details

I. General information

NPI: 1104019462
Provider Name (Legal Business Name): IRIS PARTOVI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 LINDEN AVE
LONG BEACH CA
90813-3321
US

IV. Provider business mailing address

28625 TRAILRIDERS DR
RANCHO PALOS VERDES CA
90275-3050
US

V. Phone/Fax

Practice location:
  • Phone: 562-491-9000
  • Fax:
Mailing address:
  • Phone: 408-250-3821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC153168
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number234071
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC153168
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: