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General NPI Number Information
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NPI Number | 1598884843
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Entity Type | Organization
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Legal Business Name | PARVANEH BAHMANI, M.D., INC.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST SUITE 1140E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-385-9008
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Fax | 310-499-0511
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Provider Business Mailing Address
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Address Line | PO BOX 642
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-0642
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Country | US
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Telephone | 310-508-5826
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PARVANEH BAHMANI
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Credential | M.D.
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Telephone | 310-508-5826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A 81644
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License Number State | CA
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