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General NPI Number Information
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NPI Number | 1215272059
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Entity Type | Organization
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Legal Business Name | KAMYAR KAMJOO MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 18370 BURBANK BLVD SUITE 714
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City | TARZANA
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State | CA
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Zip | 91356-2804
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Country | US
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Telephone | 310-704-6744
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 572767
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City | TARZANA
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State | CA
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Zip | 91357-2767
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Country | US
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Telephone | 310-704-6744
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | KAMYAR KAMJOO
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Credential | MD
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Telephone | 310-704-6744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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