MEDICARE: DR. HOSSEIN JADVAR 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
1	207U00000X	Nuclear Medicine Physician	G79981	CA

General Provider Information

NPI Number	:	1528009941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOSSEIN JADVAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-8541
Fax Number	:	323-442-8755

Provider Business Practice Location Address
First Line	:	1510 SAN PABLO ST FL 3
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5320
Country	:	US
Telephone Number	:	323-442-8541
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	11/27/2023

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