Provider Demographics
NPI:1386800225
Name:MAROUNI, PAYAM (MD)
Entity type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:
Last Name:MAROUNI
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:PO BOX 19211
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-9211
Mailing Address - Country:US
Mailing Address - Phone:818-988-9090
Mailing Address - Fax:
Practice Address - Street 1:8338 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-5111
Practice Address - Country:US
Practice Address - Phone:818-988-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine