MEDICARE: MAHIN AMIRGHOLAMI 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	207V00000X	Obstetrics & Gynecology Physician	A102266	CA

General Provider Information

NPI Number	:	1598943748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHIN AMIRGHOLAMI MD

Provider Business Mailing Address
First Line	:	23101 SHERMAN PL STE 40123101
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2003
Country	:	US
Telephone Number	:	818-888-6545
Fax Number	:	818-593-4563

Provider Business Practice Location Address
First Line	:	23101 SHERMAN PL STE 302
Second Line	:	23101 SHERRMAN PLACE#302
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2047
Country	:	US
Telephone Number	:	818-888-6545
Fax Number	:	818-593-4563

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

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	03/29/2019

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