MEDICARE: MAHIN ZANDIZADEH ESFAHANI MD

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	2084P0800X	Psychiatry Physician	A31491	CA

General Provider Information

NPI Number	:	1417132705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHIN ZANDIZADEH ESFAHANI MD

Provider Business Mailing Address
First Line	:	1900 E OCEAN BLVD
Second Line	:	APT 1504
City	:	LONG BEACH
State	:	CA
Zip	:	90802-6100
Country	:	US
Telephone Number	:	818-674-2890
Fax Number	:	310-424-3404

Provider Business Practice Location Address
First Line	:	3392 MOTOR AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-3712
Country	:	US
Telephone Number	:	310-858-5090
Fax Number	:	310-424-3404

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

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	04/11/2014

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