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General NPI Number Information
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NPI Number | 1134100225
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Entity Type | Organization
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Legal Business Name | GHOLAMREZA F. POURZIA, M.D., INC
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 09/04/2011
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Provider Practice Location Address
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Address Line | 2865 ATLANTIC AVE SUITE 221
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City | LONG BEACH
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State | CA
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Zip | 90806-1740
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Country | US
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Telephone | 562-595-9073
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Fax | 562-595-9076
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Provider Business Mailing Address
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Address Line | 2865 ATLANTIC AVE SUITE 221
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City | LONG BEACH
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State | CA
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Zip | 90806-1740
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Country | US
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Telephone | 562-595-9073
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Fax | 562-595-9076
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Authorized Official
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Title or Position | OWNER
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Name | DR. GHOLAMREZA FIROUZ POURZIA
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Credential | M.D.
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Telephone | 562-595-9073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A45667
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License Number State | CA
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