Provider Demographics
NPI:1851108716
Name:KAMRAN MOVASSAGHI MD PC
Entity type:Organization
Organization Name:KAMRAN MOVASSAGHI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVASSAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-640-5244
Mailing Address - Street 1:4815 SONATA LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-3248
Mailing Address - Country:US
Mailing Address - Phone:818-640-5244
Mailing Address - Fax:
Practice Address - Street 1:4815 SONATA LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-3248
Practice Address - Country:US
Practice Address - Phone:818-640-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty