# MARJAN CHEGOUNCHI MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134384407
- **Authorized official:** DR. MARJAN CHEGOUNCHI MD (OWNER)
- **Authorized official phone:** (619) 746-6530

## Contact information

- **Practice address:** 501 E HARDY ST, STE 205, INGLEWOOD, CA 90301-4054
- **Practice address phone:** (310) 671-6364
- **Practice address fax:** (310) 671-8184
- **Mailing address:** PO BOX 390005, SAN DIEGO, CA 92149-0005
- **Mailing address phone:** (619) 746-6530
- **Mailing address fax:** (619) 746-6528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RN0300X | Nephrology Physician | A80479 | CA | Yes |

## Other

- **Enumeration date:** 07/25/2008
- **Last updated:** 06/25/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | A80479 | LICENSE | CA |