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General NPI Number Information
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NPI Number | 1154669315
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Entity Type | Organization
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Legal Business Name | KATY M. SETOODEH, MD, INC
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 8750 WILSHIRE BLVD SUITE 350
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2703
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Country | US
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Telephone | 310-701-9790
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Fax | 310-595-1022
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Provider Business Mailing Address
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Address Line | 8750 WILSHIRE BLVD SUITE 350
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2703
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Country | US
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Telephone | 310-701-9790
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Fax | 310-595-1022
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Authorized Official
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Title or Position | OWNER
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Name | KATY MELODY SETOODEH
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Credential | M.D.
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Telephone | 310-701-9790
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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 | A84887
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License Number State | CA
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