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Organization
SIAMAK ETEHAD MD INC A MEDICAL CORPORATION
Active
Organization
SIAMAK ETEHAD MD INC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIAMAK P ETEHAD MD (PRESIDENT)
(800) 673-8185
Entity
Organization
Contact information
Practice address
17075 DEVONSHIRE ST, #100, NORTHRIDGE, CA 91325-1600
(818) 363-2077
(818) 363-2055
Mailing address
PO BOX 280636, NORTHRIDGE, CA 91328-0636
(818) 363-2077
(818) 363-2055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
01/04/2014
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