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General NPI Number Information
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NPI Number | 1518618164
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Entity Type | Organization
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Legal Business Name | TRIGEN MEDICAL GROUP
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 1972 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90033-1751
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Country | US
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Telephone | 818-760-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 12922 VICTORY BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-2924
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Country | US
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Telephone | 818-760-2800
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Fax | 818-760-7343
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | SOROUSH ADAM RAMIN
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Credential | MD
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Telephone | 818-760-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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