MEDICARE: DR. MOISE DANIELPOUR 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	207T00000X	Neurological Surgery Physician	G85309	CA

General Provider Information

NPI Number	:	1881655116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOISE DANIELPOUR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 512717
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0717
Country	:	US
Telephone Number	:	310-423-7900
Fax Number	:	310-423-0810

Provider Business Practice Location Address
First Line	:	8700 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-1804
Country	:	US
Telephone Number	:	310-423-7900
Fax Number	:	310-423-0810

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/21/2014

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