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General NPI Number Information
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NPI Number | 1225047509
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Entity Type | Organization
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Legal Business Name | A. EBBIE SOROUDI, MD, MS A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 8900 WILSHIRE BLVD STE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1959
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Country | US
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Telephone | 310-474-2010
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Fax | 310-474-2009
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Provider Business Mailing Address
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Address Line | 8900 WILSHIRE BLVD STE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1959
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Country | US
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Telephone | 310-474-2010
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Fax | 310-474-2009
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Authorized Official
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Title or Position | A PROFESSIONAL MEDICAL CORPORATION
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Name | DR. ABRAHAM EBBIE SOROUDI
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Credential | MD, MS
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Telephone | 310-770-7836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A75978
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License Number State | CA
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