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Organization
SAN JUDAS MEDICAL GROUP WEST
Active
Organization
SAN JUDAS MEDICAL GROUP WEST
Active
Other names
N. ROSTAMI MEDICAL GROUP, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEJAT ROSTAMI M.D. (MEDICAL DIRECTOR)
(323) 957-8787
Entity
Organization
Contact information
Practice address
1080 N WESTERN AVE, LOS ANGELES, CA 90029-2310
(323) 957-8787
(323) 957-8777
Mailing address
1080 N WESTERN AVE, LOS ANGELES, CA 90029-2310
(323) 957-8787
(323) 957-8777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A48731
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0067430
—
CA
Enumeration date
02/01/2007
Last updated
09/22/2016
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