MEDICARE: MEDHI IZADI, DO 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1366868606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDHI IZADI, DO INC

Provider Business Mailing Address
First Line	:	7301 MEDICAL CENTER DR STE 302
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1975
Country	:	US
Telephone Number	:	818-888-3387
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 MEDICAL CENTER DR STE 302
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1975
Country	:	US
Telephone Number	:	818-888-3387
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. MEHDI IZADI
Credential	:	DO
Telephone Number	:	818-888-3387

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/11/2014

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