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General NPI Number Information
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NPI Number | 1922423516
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Entity Type | Organization
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Legal Business Name | NASTARAN RAFIEI, M.D. INC
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD STE 680
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City | ENCINO
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State | CA
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Zip | 91436-4321
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Country | US
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Telephone | 818-268-8410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8956
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City | CALABASAS
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State | CA
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Zip | 91372-8956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NASTARAN RAFIEI
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Credential | M.D.
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Telephone | 310-717-2829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A100901
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License Number State | CA
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