MEDICARE: AKHTAR GOLBAHAR

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	246XS1301X	Sonography Specialist/Technologist Cardiovascular

General Provider Information

NPI Number	:	1659497972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKHTAR GOLBAHAR

Provider Business Mailing Address
First Line	:	16461 SLOAN DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-1157
Country	:	US
Telephone Number	:	818-324-1156
Fax Number	:	818-508-1726

Provider Business Practice Location Address
First Line	:	10847 BURBANK BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2521
Country	:	US
Telephone Number	:	818-324-1156
Fax Number	:	818-508-1726

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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Directions to “ AKHTAR GOLBAHAR ” Practice Location

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