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General NPI Number Information
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NPI Number | 1578835724
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Entity Type | Organization
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Legal Business Name | MEHBOOB MAKHANI MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 10/03/2020
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Provider Practice Location Address
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Address Line | 17075 DEVONSHIRE ST SUITE 204
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City | NORTHRIDGE
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State | CA
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Zip | 91325-1600
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Country | US
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Telephone | 818-717-8464
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Fax | 818-530-7880
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Provider Business Mailing Address
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Address Line | 20211 VIA MEDICI
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City | NORTHRIDGE
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State | CA
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Zip | 91326-4059
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Country | US
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Telephone | 818-717-8464
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Fax | 818-530-7880
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Authorized Official
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Title or Position | PRESIDENT
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Name | MEHBOOB MAKHANI
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Credential | M.D.
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Telephone | 818-717-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A64828
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License Number State | CA
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