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General NPI Number Information
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NPI Number | 1952568305
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Entity Type | Organization
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Legal Business Name | PAYAM DANESHRAD MD INC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1304 15TH ST STE 407
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City | SANTA MONICA
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State | CA
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Zip | 90404-1813
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Country | US
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Telephone | 310-453-6500
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Fax | 310-453-6681
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Provider Business Mailing Address
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Address Line | 1304 15TH ST STE 407
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City | SANTA MONICA
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State | CA
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Zip | 90404-1813
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Country | US
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Telephone | 310-453-6500
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Fax | 310-453-6681
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAYAM DANESHRAD
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Credential |
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Telephone | 310-453-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A71327
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License Number State | CA
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