MEDICARE: NAVA HOSSEINNEZHAD BAHRAMJERDI

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	363LA2200X	Adult Health Nurse Practitioner	95036973	CA

General Provider Information

NPI Number	:	1205542669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAVA HOSSEINNEZHAD BAHRAMJERDI

Provider Business Mailing Address
First Line	:	3925 E 3RD ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-2802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 E 3RD ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-2802
Country	:	US
Telephone Number	:	617-602-9638
Fax Number	:

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

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	02/11/2026

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