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General NPI Number Information
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NPI Number | 1356498976
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Entity Type | Organization
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Legal Business Name | PEYMAN GHASRI, MD, A PROF CORP.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 18555 VENTURA BLVD SUITE E
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 818-344-3376
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Fax | 818-334-3396
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Provider Business Mailing Address
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Address Line | 18555 VENTURA BLVD SUITE E
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 818-344-3376
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Fax | 818-334-3396
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEYMAN GHASRI
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Credential | MD
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Telephone | 813-344-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A83809
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License Number State | CA
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