Healthcare Provider Details

I. General information

NPI: 1669749149
Provider Name (Legal Business Name): ROBERT NARAGHI, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W 3RD ST STE 500
LOS ANGELES CA
90057-1932
US

IV. Provider business mailing address

15332 ANTIOCH ST #874
PACIFIC PALISADES CA
90272-3628
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-5551
  • Fax: 213-207-5815
Mailing address:
  • Phone: 213-484-5551
  • Fax: 213-207-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberG83950
License Number StateCA

VIII. Authorized Official

Name: ROBERT M NARAGHI
Title or Position: MD, PRESIDENT
Credential: MD
Phone: 213-484-5551