MEDICARE: GHOLAMREZA F. POURZIA, M.D., INC

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	207RC0000X	Cardiovascular Disease Physician	A45667	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	:	1134100225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GHOLAMREZA F. POURZIA, M.D., INC

Provider Business Mailing Address
First Line	:	2865 ATLANTIC AVE
Second Line	:	SUITE 221
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1740
Country	:	US
Telephone Number	:	562-595-9073
Fax Number	:	562-595-9076

Provider Business Practice Location Address
First Line	:	2865 ATLANTIC AVE
Second Line	:	SUITE 221
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1740
Country	:	US
Telephone Number	:	562-595-9073
Fax Number	:	562-595-9076

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GHOLAMREZA FIROUZ POURZIA
Credential	:	M.D.
Telephone Number	:	562-595-9073

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	09/04/2011

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Directions to “GHOLAMREZA F. POURZIA, M.D., INC ” Practice Location

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