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General NPI Number Information
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NPI Number | 1396012555
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Entity Type | Organization
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Legal Business Name | ABTIN FOROOHAR MD INC
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 16661 VENTURA BLVD #707
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City | ENCINO
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State | CA
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Zip | 91436-1914
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Country | US
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Telephone | 310-770-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 16661 VENTURA BLVD #707
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City | ENCINO
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State | CA
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Zip | 91436-1914
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Country | US
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Telephone | 310-770-4271
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Fax |
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Authorized Official
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Title or Position | FOUNDER/ CEO
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Name | DR. ABTIN FOROOHAR
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Credential | MD
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Telephone | 310-770-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A117048
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License Number State | CA
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