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General NPI Number Information
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NPI Number | 1295842599
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Entity Type | Organization
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Legal Business Name | BIJAN MOTAGHEDI M. D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 501 RUE DE SANTE SUITE #11
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City | LA PLACE
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State | LA
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Zip | 70068-5400
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Country | US
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Telephone | 985-652-4229
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Fax | 985-652-4270
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Provider Business Mailing Address
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Address Line | 501 RUE DE SANTE SUITE #11
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City | LA PLACE
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State | LA
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Zip | 70068-5400
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Country | US
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Telephone | 985-652-4229
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Fax | 985-652-4270
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Authorized Official
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Title or Position | PRESIDENT/SOLO PRACTI.
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Name | DR. BIJAN MOTAGHEDI
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Credential | M.D.
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Telephone | 985-652-4229
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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 | 04347R
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License Number State | LA
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