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General NPI Number Information
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NPI Number | 1952824872
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Entity Type | Individual
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Provider Name | HAMID EHSANI NIA DO
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Gender | Male
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 21835 VENTURA BLVD STE 21837
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1838
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Country | US
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Telephone | 818-600-7348
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Fax | 888-972-1912
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Provider Business Mailing Address
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Address Line | 256 DOWN HILL RUN
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1021
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Country | US
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Telephone | 818-357-0976
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB10748200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 308858
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A20175
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License Number State | CA
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