MEDICARE: DR. PIROOZ SABOORTINAT MOFRAD 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	207R00000X	Internal Medicine Physician	A92949	CA
2	207RC0000X	Cardiovascular Disease Physician	A92949	CA
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	A92949	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699865758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIROOZ SABOORTINAT MOFRAD MD

Provider Business Mailing Address
First Line	:	10230 NEW HAMPSHIRE AVE
Second Line	:	SUITE 204
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1400
Country	:	US
Telephone Number	:	301-408-7890
Fax Number	:

Provider Business Practice Location Address
First Line	:	10230 NEW HAMPSHIRE AVE
Second Line	:	SUITE 204
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1400
Country	:	US
Telephone Number	:	301-408-7890
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/20/2010

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Directions to “ DR. PIROOZ SABOORTINAT MOFRAD MD” Practice Location

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