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General NPI Number Information
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NPI Number | 1639520133
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Entity Type | Individual
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Provider Name | EMAD MOGADAM
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Gender | Male
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Dates
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Enumeration Date | 06/26/2016
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1513 S GRAND AVE STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90015-3075
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Country | US
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Telephone | 530-208-9214
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 S FIGUEROA ST STE D-282
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City | LOS ANGELES
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State | CA
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Zip | 90015-2873
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Country | US
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Telephone | 716-200-2771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 24198
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A151414
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 26369
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A151414
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License Number State | CA
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