MEDICARE: DR. KOUROSH NOORMAND M.D.

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	A50982	CA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	A50982	CA

General Provider Information

NPI Number	:	1750357182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KOUROSH NOORMAND M.D.

Provider Business Mailing Address
First Line	:	PO BOX 16713
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90209-2713
Country	:	US
Telephone Number	:	818-497-3797
Fax Number	:	310-888-7719

Provider Business Practice Location Address
First Line	:	1016 S ROBERTSON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1505
Country	:	US
Telephone Number	:	818-497-3797
Fax Number	:	310-888-7719

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

Provider Enumeration Date	:	02/25/2006
Last Update Date	:	05/23/2016

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