MEDICARE: DR. REZA RAMAZANKHANI 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	207L00000X	Anesthesiology Physician	37501	KY
2	207L00000X	Anesthesiology Physician	A77800	CA

General Provider Information

NPI Number	:	1770554933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZA RAMAZANKHANI MD

Provider Business Mailing Address
First Line	:	1215 ARMACOST AVE APT 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1443
Country	:	US
Telephone Number	:	858-525-1963
Fax Number	:	877-852-5845

Provider Business Practice Location Address
First Line	:	1215 ARMACOST AVE APT 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1443
Country	:	US
Telephone Number	:	858-525-1963
Fax Number	:	877-852-5845

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	12/10/2014

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