Provider Demographics
NPI:1386493906
Name:MORADI, KOUROSH (MD)
Entity type:Individual
Prefix:DR
First Name:KOUROSH
Middle Name:
Last Name:MORADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KOUROSH
Other - Middle Name:
Other - Last Name:MORADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:21250 CALIFA ST STE 114
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-5023
Mailing Address - Country:US
Mailing Address - Phone:818-518-3480
Mailing Address - Fax:
Practice Address - Street 1:21250 CALIFA ST STE 114
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-5023
Practice Address - Country:US
Practice Address - Phone:818-518-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program