# B MOUSSAZADEH A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1376043513
- **Authorized official:** MRS. CHEYENNE KAIPAT (OFFICE MANAGER)
- **Authorized official phone:** (818) 588-4741

## Contact information

- **Practice address:** 5620 WILBUR AVE STE 305, TARZANA, CA 91356-1311
- **Practice address phone:** (818) 588-4741
- **Practice address fax:** (818) 588-4748
- **Mailing address:** 5620 WILBUR AVE STE 305, TARZANA, CA 91356-1311
- **Mailing address phone:** (818) 588-4741
- **Mailing address fax:** (818) 588-4748

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | A108651 | CA | Yes |

## Other

- **Enumeration date:** 02/14/2018
- **Last updated:** 03/03/2020