Provider Demographics
NPI:1720465578
Name:PEDRAM NAVAB DO INC
Entity type:Organization
Organization Name:PEDRAM NAVAB DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OSTEOPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-416-4511
Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:SUITE W201
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:760-416-4511
Mailing Address - Fax:760-416-4515
Practice Address - Street 1:1180 N INDIAN CANYON DRIVE
Practice Address - Street 2:SUITE W201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4402
Practice Address - Country:US
Practice Address - Phone:760-416-4511
Practice Address - Fax:760-416-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Multi-Specialty