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General NPI Number Information
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NPI Number | 1346481645
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Entity Type | Individual
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Provider Name | RAMYAR MAHDAVI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 1511 W GLENOAKS BLVD
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City | GLENDALE
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State | CA
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Zip | 91201-1912
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Country | US
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Telephone | 818-637-2200
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Fax | 818-637-2250
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Provider Business Mailing Address
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Address Line | 3426 RED ROSE DR
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City | ENCINO
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State | CA
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Zip | 91436-4214
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Country | US
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Telephone | 818-300-6191
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 62403-20
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License Number State | WI
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