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General NPI Number Information
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NPI Number | 1790989028
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Entity Type | Individual
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Provider Name | LADAN AYATOLLAHI CNM, RN, MS
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 8077 FLORENCE AVE STE 112
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City | DOWNEY
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State | CA
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Zip | 90240-3894
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Country | US
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Telephone | 562-904-6031
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Fax | 562-904-6033
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Provider Business Mailing Address
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Address Line | 8077 FLORENCE AVE STE 112
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City | DOWNEY
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State | CA
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Zip | 90240-3894
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Country | US
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Telephone | 562-904-6031
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 001179
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 95067203
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License Number State | CA
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