Healthcare Provider Details

I. General information

NPI: 1326160862
Provider Name (Legal Business Name): TOURAGE SOLEIMANI, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E SUITE 1405
LOS ANGELES CA
90067-2001
US

IV. Provider business mailing address

2080 CENTURY PARK E SUITE 1405
LOS ANGELES CA
90067-2001
US

V. Phone/Fax

Practice location:
  • Phone: 310-277-7707
  • Fax:
Mailing address:
  • Phone: 310-277-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberA35797
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA35797
License Number StateCA

VIII. Authorized Official

Name: DR. TOURAGE SOLEIMANI
Title or Position: PRESIDENT
Credential: MEDICAL DOCTOR
Phone: 310-277-7707