Provider Demographics
NPI:1699735118
Name:RAZANI, JAVAD (MD)
Entity type:Individual
Prefix:
First Name:JAVAD
Middle Name:
Last Name:RAZANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 491998
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-8998
Mailing Address - Country:US
Mailing Address - Phone:310-967-7774
Mailing Address - Fax:310-471-0836
Practice Address - Street 1:9301 WILSHIRE BLVD
Practice Address - Street 2:STE 509
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5424
Practice Address - Country:US
Practice Address - Phone:310-967-7774
Practice Address - Fax:310-471-0836
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2014-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG150842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A39426Medicare UPIN