Healthcare Provider Details

I. General information

NPI: 1366620742
Provider Name (Legal Business Name): HOOSHANG SEMNANI MD. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

IV. Provider business mailing address

2934 1/2 N BEVERLY GLEN CIR BOX 21
LOS ANGELES CA
90077-1724
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-5349
  • Fax: 818-885-5448
Mailing address:
  • Phone: 818-882-2441
  • Fax: 818-882-2466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA41158
License Number StateCA

VIII. Authorized Official

Name: DR. HOOSHANG SEMNANI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-885-5349