Provider Demographics
NPI:1699093062
Name:PARVIN AMINI MIRABADI M D A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PARVIN AMINI MIRABADI M D A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-285-2550
Mailing Address - Street 1:14600 SHERMANWAY
Mailing Address - Street 2:200
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-5850
Mailing Address - Country:US
Mailing Address - Phone:818-782-0004
Mailing Address - Fax:818-782-0555
Practice Address - Street 1:14600 SHERMAN WAY
Practice Address - Street 2:200
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2283
Practice Address - Country:US
Practice Address - Phone:818-782-0004
Practice Address - Fax:818-782-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC433020207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty