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NPI Code Detail

MEDICARE: NEEMA HEIVAND

MEDICARE: NEEMA HEIVAND
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianA141875CA

General Provider Information

NPI Number : 1952667040
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEEMA HEIVAND
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-301-8707
Fax Number :
Provider Business Practice Location Address
First Line : 100 MOODY CT STE 200
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-6082
Country : US
Telephone Number : 805-418-3500
Fax Number : 805-418-3505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2012
Last Update Date : 03/17/2018

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Directions to “ NEEMA HEIVAND ” Practice Location

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