Provider Demographics
NPI:1215045968
Name:TAHERI-TAFRESHI, ANOSHIRAVAN (MD)
Entity type:Individual
Prefix:
First Name:ANOSHIRAVAN
Middle Name:
Last Name:TAHERI-TAFRESHI
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 1:921 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2944
Mailing Address - Country:US
Mailing Address - Phone:310-208-7773
Mailing Address - Fax:310-208-7753
Practice Address - Street 1:921 WESTWOOD BLVD
Practice Address - Street 2:SUITE 232
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2944
Practice Address - Country:US
Practice Address - Phone:310-208-7773
Practice Address - Fax:310-208-7753
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA778102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry