MEDICARE: EIMAN FIROOZMAND 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	208C00000X	Colon & Rectal Surgery Physician	A65759	CA
2	208600000X	Surgery Physician	A65759	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D1002337	OTHER	CA	CLIA NO
2	352174655	OTHER	CA	FEDERAL TAX ID

General Provider Information

NPI Number	:	1053322719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EIMAN FIROOZMAND M.D.

Provider Business Mailing Address
First Line	:	9400 BRIGHTON WAY
Second Line	:	SUITE 307
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4703
Country	:	US
Telephone Number	:	310-273-2310
Fax Number	:	310-273-0314

Provider Business Practice Location Address
First Line	:	9400 BRIGHTON WAY
Second Line	:	SUITE 307
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4703
Country	:	US
Telephone Number	:	310-273-2310
Fax Number	:	310-273-0314

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	12/24/2009

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Directions to “ EIMAN FIROOZMAND M.D.” Practice Location

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