MEDICARE: GREGORY JAHANGIRI D.O.

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	20A5721	CA

General Provider Information

NPI Number	:	1689854986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY JAHANGIRI D.O.

Provider Business Mailing Address
First Line	:	3004 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1637
Country	:	US
Telephone Number	:	323-264-0535
Fax Number	:	323-264-0061

Provider Business Practice Location Address
First Line	:	3004 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1637
Country	:	US
Telephone Number	:	323-264-0535
Fax Number	:	323-264-0535

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

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	05/04/2016

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