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Organization
WEST VALLEY INTENSIVIST MEDICAL CORPORATION
Active
Organization
WEST VALLEY INTENSIVIST MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRYAR THOMAS YADEGAR M.D. (OWNER)
(818) 609-7536
Entity
Organization
Contact information
Practice address
18399 VENTURA BLVD, SUITE 245, TARZANA, CA 91356-4233
(818) 609-7536
(818) 344-9670
Mailing address
18399 VENTURA BLVD, SUITE 245, TARZANA, CA 91356-4233
(818) 609-7536
(818) 344-9670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A61475
CA
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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