Provider Demographics
NPI:1063408185
Name:OZGUR, MEHMET H (MD)
Entity type:Individual
Prefix:
First Name:MEHMET
Middle Name:H
Last Name:OZGUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2106 RIMCREST DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1057
Mailing Address - Country:US
Mailing Address - Phone:818-366-8250
Mailing Address - Fax:818-366-8245
Practice Address - Street 1:17075 DEVONSHIRE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1600
Practice Address - Country:US
Practice Address - Phone:818-366-8250
Practice Address - Fax:818-366-8245
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA32040207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A320400Medicaid
A26680Medicare UPIN
CAA32040Medicare PIN