Provider Demographics
NPI:1306165857
Name:GUNN, NAZANIN IZADPANAH (MD, MHA)
Entity type:Individual
Prefix:DR
First Name:NAZANIN
Middle Name:IZADPANAH
Last Name:GUNN
Suffix:
Gender:F
Credentials:MD, MHA
Other - Prefix:DR
Other - First Name:NAZANIN
Other - Middle Name:
Other - Last Name:IZADPANAH GUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MHA
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MOODY CT
Practice Address - Street 2:SUITE 200
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6077
Practice Address - Country:US
Practice Address - Phone:805-418-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine