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General NPI Number Information
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NPI Number | 1144368887
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Entity Type | Organization
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Legal Business Name | LAUREL MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 415 WALKER DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-1842
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Country | US
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Telephone | 818-897-7730
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Fax | 818-897-7831
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Provider Business Mailing Address
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Address Line | 13680 VAN NUYS BLVD
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City | PACOIMA
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State | CA
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Zip | 91331-3616
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Country | US
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Telephone | 818-897-7730
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Fax | 818-897-7831
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PARVIZ TAHERI
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Credential | M.D.
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Telephone | 818-897-7730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A42680
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License Number State | CA
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