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NPI Code Detail

MEDICARE: KHATEREH A ASSADI M.D.

MEDICARE:   KHATEREH A ASSADI  M.D.
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
1207Q00000XFamily Medicine Physician036129322IL
2207Q00000XFamily Medicine PhysicianC154956CA

General Provider Information

NPI Number : 1427327766
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHATEREH A ASSADI M.D.
Provider Business Mailing Address
First Line : 741 S ALVARADO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-4021
Country : US
Telephone Number : 213-413-6666
Fax Number : 213-351-9504
Provider Business Practice Location Address
First Line : 741 S ALVARADO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-4021
Country : US
Telephone Number : 213-413-6666
Fax Number : 213-351-9504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2011
Last Update Date : 06/02/2021

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Directions to “ KHATEREH A ASSADI M.D.” Practice Location

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