Provider Demographics
NPI:1154743052
Name:RAMIN GHAYOORI MD,INC
Entity type:Organization
Organization Name:RAMIN GHAYOORI MD,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAYOORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-560-5189
Mailing Address - Street 1:PO BOX 50203
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91614-5020
Mailing Address - Country:US
Mailing Address - Phone:212-729-3606
Mailing Address - Fax:
Practice Address - Street 1:12626 RIVERSIDE DR STE 101
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3448
Practice Address - Country:US
Practice Address - Phone:310-560-5189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-11
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104182207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1922297357Medicaid
CA1922297357OtherMEDI-CAL