MEDICARE: MR. BAHRAM NAMDARI 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	207L00000X	Anesthesiology Physician	13878	CA

General Provider Information

NPI Number	:	1730479700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BAHRAM NAMDARI D.O

Provider Business Mailing Address
First Line	:	1609 RAMONA DR
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-7401
Country	:	US
Telephone Number	:	818-917-4821
Fax Number	:

Provider Business Practice Location Address
First Line	:	696 HAMPSHIRE RD STE 100
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4456
Country	:	US
Telephone Number	:	805-413-7921
Fax Number	:

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

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	01/27/2021

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