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General NPI Number Information
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NPI Number | 1790344869
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Entity Type | Organization
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Legal Business Name | GHODS INC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 955 CARRILLO DR STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90048-5475
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Country | US
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Telephone | 424-258-0124
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Fax | 310-602-6515
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Provider Business Mailing Address
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Address Line | 955 CARRILLO DR STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90048-5475
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Country | US
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Telephone | 424-258-0124
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Fax | 310-602-6515
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MICHAEL JACOB GHODS
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Credential | MD
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Telephone | 424-258-0124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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Taxonomy #2
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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