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General NPI Number Information
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NPI Number | 1750495628
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Entity Type | Individual
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Provider Name | JEHAN ZEB MIR MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 301 N PRAIRIE AVE 120
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City | INGLEWOOD
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State | CA
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Zip | 90301-4507
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Country | US
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Telephone | 310-677-6101
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Fax | 310-677-9327
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Provider Business Mailing Address
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Address Line | 1715 VIA EL PRADO 64
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City | REDONDO BEACH
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State | CA
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Zip | 90277-5713
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Country | US
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Telephone | 310-951-9175
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Fax | 310-375-1055
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A24647
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A24647
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A24647
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | A24647
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License Number State | CA
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