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General NPI Number Information
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NPI Number | 1881975761
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Entity Type | Organization
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Legal Business Name | JOSEPH S. GHAZAL, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 1300 N VERMONT AVE STE 808
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City | LOS ANGELES
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State | CA
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Zip | 90027-6005
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Country | US
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Telephone | 323-913-4303
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Fax | 323-913-4361
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Provider Business Mailing Address
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Address Line | 1300 N VERMONT AVE STE 808
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City | LOS ANGELES
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State | CA
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Zip | 90027-6005
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Country | US
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Telephone | 323-913-4303
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Fax | 323-913-4361
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH SAMIR GHAZAL
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Credential | M.D.
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Telephone | 323-913-4303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C53712
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License Number State | CA
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