=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033679469
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PEJMAN MAJD MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2019
-----------------------------------------------------
Last Update Date | 06/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 N BRENT ST
-----------------------------------------------------
City | VENTURA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93003-2809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-948-5011
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 CITY BLVD W STE 2150
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92868-5920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-456-6661
-----------------------------------------------------
Fax | 714-456-7702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | A179006
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------