# ETEHAD M.D., INC

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

## Provider details

- **NPI number:** 1144789975
- **Authorized official:** SIAMAK P ETEHAD MD (PRESIDENT)
- **Authorized official phone:** (818) 812-9466

## Contact information

- **Practice address:** 7667 WINNETKA AVE, WINNETKA, CA 91306-2677
- **Practice address phone:** (818) 812-9466
- **Mailing address:** 7667 WINNETKA AVE, WINNETKA, CA 91306-2677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2019
- **Last updated:** 03/19/2019