MEDICARE: DR. DARIUS GHARIB M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A42217	CA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A42217	CA
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A42217	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013929918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARIUS GHARIB M.D.

Provider Business Mailing Address
First Line	:	16133 VENTURA BLVD
Second Line	:	350
City	:	ENCINO
State	:	CA
Zip	:	91436-2403
Country	:	US
Telephone Number	:	818-501-5201
Fax Number	:	818-530-5322

Provider Business Practice Location Address
First Line	:	16133 VENTURA BLVD
Second Line	:	350
City	:	ENCINO
State	:	CA
Zip	:	91436-2403
Country	:	US
Telephone Number	:	818-501-5201
Fax Number	:	818-530-5322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	11/07/2013

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