Provider Demographics
NPI:1124052311
Name:GOLZARI, MAJID (MD)
Entity type:Individual
Prefix:DR
First Name:MAJID
Middle Name:
Last Name:GOLZARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2816
Mailing Address - Country:US
Mailing Address - Phone:805-496-4200
Mailing Address - Fax:805-496-7372
Practice Address - Street 1:1141 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2816
Practice Address - Country:US
Practice Address - Phone:805-496-4200
Practice Address - Fax:805-496-7372
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45433208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A454331Medicaid
CA00A454331Medicaid
CAWA45433AMedicare Oscar/Certification