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Organization
REZA BONABI MD, INC
Active
Organization
REZA BONABI MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGADEH GHOLAMREZA BONABI M.D. (PHYSICIAN)
(818) 368-4212
Entity
Organization
Contact information
Practice address
17075 DEVONSHIRE ST, SUITE 301, NORTHRIDGE, CA 91325-1600
(818) 368-4212
(818) 366-9351
Mailing address
17075 DEVONSHIRE ST, SUITE 301, NORTHRIDGE, CA 91325-1600
(818) 368-4212
(818) 366-9351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A46355
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A463550
—
CA
Enumeration date
07/23/2008
Last updated
07/23/2008
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