Provider Demographics
NPI:1386711687
Name:MARGHZAR, SOHEIL SOL (AUD)
Entity type:Individual
Prefix:DR
First Name:SOHEIL
Middle Name:SOL
Last Name:MARGHZAR
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:SOL
Other - Middle Name:
Other - Last Name:MARGHZAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:3831 HUGHES AVE
Mailing Address - Street 2:SUITE 600 B
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2751
Mailing Address - Country:US
Mailing Address - Phone:310-559-4884
Mailing Address - Fax:310-204-3175
Practice Address - Street 1:3831 HUGHES AVE
Practice Address - Street 2:SUITE 600 B
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2751
Practice Address - Country:US
Practice Address - Phone:310-559-4884
Practice Address - Fax:310-204-3175
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1530231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ51444ZOtherBLUE SHIELD CULVER CITY
CAAU0015300Medicaid
CAAU0015301Medicaid
CAGAU000240Medicaid
CAZZZ42713ZOtherBLUE SHIELD BEVERLY HILLS
CAR13953Medicare UPIN
CAAUD1530Medicare ID - Type UnspecifiedMEDICARE (CULVER CITY)
CAAUD1530BMedicare ID - Type UnspecifiedMEDICARE (BEVERLY HILLS)
CAGAU000240Medicaid
CAHC592ZMedicare PIN