Provider Demographics
NPI:1427673573
Name:BOBBY NOURANI D.O MEDICAL CORPORATION
Entity type:Organization
Organization Name:BOBBY NOURANI D.O MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-546-2811
Mailing Address - Street 1:21 7TH PL APT 709
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-5872
Mailing Address - Country:US
Mailing Address - Phone:562-546-2811
Mailing Address - Fax:810-202-7549
Practice Address - Street 1:21 7TH PL APT 709
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-5872
Practice Address - Country:US
Practice Address - Phone:562-546-2811
Practice Address - Fax:810-202-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty