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NPI Code Detail

MEDICARE: CYNTHIA CHAGHOURI PA

MEDICARE: CYNTHIA CHAGHOURI PA
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
1363A00000XPhysician AssistantPA 21065CA

General Provider Information

NPI Number : 1124337910
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA CHAGHOURI PA
Provider Business Mailing Address
First Line : 3009 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-3033
Country : US
Telephone Number : 323-730-1663
Fax Number : 323-730-9961
Provider Business Practice Location Address
First Line : 3009 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-3033
Country : US
Telephone Number : 323-730-1663
Fax Number : 323-730-9961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2010
Last Update Date : 01/06/2011

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Directions to “ CYNTHIA CHAGHOURI PA” Practice Location

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