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Organization
JAVID GHANDEHARI, MD, A CALIFORNIA MEDICAL CORPORATION
Active
Organization
JAVID GHANDEHARI, MD, A CALIFORNIA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVID GHANDEHARI MD (OWNER)
(210) 845-6268
Entity
Organization
Contact information
Practice address
1328 22ND ST, SANTA MONICA, CA 90404-2032
(310) 829-5511
Mailing address
150 W CIVIC CENTER DR STE 200, SANDY, UT 84070-4284
(888) 854-3822
(770) 701-6673
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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