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General NPI Number Information
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NPI Number | 1699216333
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Entity Type | Organization
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Legal Business Name | AMIR LARIAN MD INC
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 1624 W OLIVE AVE SUITE B
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City | BURBANK
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State | CA
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Zip | 91506-2459
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Country | US
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Telephone | 818-729-9149
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Fax | 818-729-9149
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Provider Business Mailing Address
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Address Line | 1624 W OLIVE AVE SUITE B
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City | BURBANK
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State | CA
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Zip | 91506-2459
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Country | US
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Telephone | 818-729-9149
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Fax | 818-729-9149
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Authorized Official
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Title or Position | CEO
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Name | AMIR LARIAN
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Credential | MD
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Telephone | 818-729-9149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A118659
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License Number State | CA
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