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General NPI Number Information
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NPI Number | 1174750061
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Entity Type | Organization
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Legal Business Name | RUZMED INC
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR SUITE 203B
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-599-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 2658 GRIFFITH PARK BLVD SUITE 180
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City | LOS ANGELES
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State | CA
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Zip | 90039-2520
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Country | US
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Telephone | 323-599-3303
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KHOSROW MEHDI NAFISI
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Credential | M.D.
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Telephone | 323-599-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A40818
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License Number State | CA
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