MEDICARE: DR. F. DANIEL KHARRAZI 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	G083471	CA
2	207X00000X	Orthopaedic Surgery Physician	G83471	CA

General Provider Information

NPI Number	:	1851376750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. F. DANIEL KHARRAZI MD

Provider Business Mailing Address
First Line	:	6801 PARK TER
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-1543
Country	:	US
Telephone Number	:	310-665-7200
Fax Number	:	310-215-3966

Provider Business Practice Location Address
First Line	:	6801 PARK TER
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-1543
Country	:	US
Telephone Number	:	310-665-7200
Fax Number	:	310-215-3966

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	10/18/2021

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