Healthcare Provider Details

I. General information

NPI: 1720465578
Provider Name (Legal Business Name): PEDRAM NAVAB DO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 05/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DRIVE SUITE W201
PALM SPRINGS CA
92262-4402
US

IV. Provider business mailing address

1180 N INDIAN CANYON DR SUITE W201
PALM SPRINGS CA
92262-4800
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4511
  • Fax: 760-416-4515
Mailing address:
  • Phone: 760-416-4511
  • Fax: 760-416-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PEDRAM NAVAB
Title or Position: OSTEOPATHIC DOCTOR
Credential: D.O.
Phone: 760-416-4511