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General NPI Number Information
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NPI Number | 1194083105
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Entity Type | Individual
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Provider Name | MERSEDEH BAHR HOSSEINI
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Gender | Female
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 3311 RIVERBEND DR. NEUROHOSPITALISTS
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City | SPRINGFIELD
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State | OR
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Zip | 97477
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Country | US
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Telephone | 541-222-5144
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Fax | 541-338-1070
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A137503
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD187494
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License Number State | OR
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