Healthcare Provider Details

I. General information

NPI: 1407071327
Provider Name (Legal Business Name): PARIA HASSOURI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8733 BEVERLY BLVD STE 200
WEST HOLLYWOOD CA
90048-1844
US

IV. Provider business mailing address

8733 BEVERLY BLVD STE 200
WEST HOLLYWOOD CA
90048-1844
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-3981
  • Fax:
Mailing address:
  • Phone: 310-652-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA97799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: