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General NPI Number Information
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NPI Number | 1053426700
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Entity Type | Individual
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Provider Name | AMIR SHAHRAM MAKOUI MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 615 WEST AVE Q SUITE D
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City | PALMDALE
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State | CA
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Zip | 93551
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Country | US
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Telephone | 661-266-4500
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Fax | 661-266-4502
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Provider Business Mailing Address
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Address Line | PO BOX 4008
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City | LANCASTER
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State | CA
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Zip | 93539-4008
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Country | US
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Telephone | 661-266-4500
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Fax | 661-266-4502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | A75531
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License Number State | CA
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