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General NPI Number Information
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NPI Number | 1700143104
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Entity Type | Individual
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Provider Name | KOUROSH MICHAEL KOLAHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 3633 LONG BEACH BLVD STE 100
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City | LONG BEACH
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State | CA
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Zip | 90807-6027
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Country | US
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Telephone | 562-424-9000
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Fax | 562-424-9067
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Provider Business Mailing Address
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Address Line | 3633 LONG BEACH BLVD STE 100
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City | LONG BEACH
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State | CA
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Zip | 90807-6027
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Country | US
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Telephone | 562-424-9000
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Fax | 562-424-9067
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | A127417
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License Number State | CA
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