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General NPI Number Information
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NPI Number | 1972915478
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Entity Type | Organization
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Legal Business Name | PANORAMA PULMONARY CONSULTANTS, INC.
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 726 4TH ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5656
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Country | US
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Telephone | 818-430-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 4850 BENTWOOD WAY
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City | GRANITE BAY
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State | CA
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Zip | 95746-6401
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Country | US
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Telephone | 818-430-4519
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Fax |
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Authorized Official
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Title or Position | CONSULTANT PHYSICIAN
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Name | DR. NASROLLAH AHMADPOUR
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Credential |
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Telephone | 818-430-4519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | A105326
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License Number State | CA
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