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General NPI Number Information
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NPI Number | 1871526301
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Entity Type | Individual
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Provider Name | POUYA BAHRAMI DO
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 1414 S GRAND AVE SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90015-3067
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Country | US
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Telephone | 213-481-2200
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Fax | 213-481-7023
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Provider Business Mailing Address
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Address Line | 1414 S GRAND AVE STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90015-3067
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Country | US
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Telephone | 213-481-2200
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Fax | 213-481-7023
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A7262
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License Number State | CA
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