# AMIR HEDAYATI-RAD M D INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1659578110
- **Authorized official:** DR. AMIR H HEDAYATI-RAD M.D. (OWNER)
- **Authorized official phone:** (818) 507-6404

## Contact information

- **Practice address:** 706 W BROADWAY \# 100, GLENDALE, CA 91204-1032
- **Practice address phone:** (818) 507-6404
- **Practice address fax:** (818) 507-6406
- **Mailing address:** 163 GRANDVILLE AVENUE, LOS ANGELES, CA 90049-4224
- **Mailing address phone:** (818) 507-6404
- **Mailing address fax:** (818) 507-6406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | A60239 | CA | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | A60239 | CA | Yes |
| 207RI0011X | Interventional Cardiology Physician | A60239 | CA | — |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 05/20/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A602390 | — | CA |
| 01 | — | DE8474 | RAILROAD MEDICARE GRP | CA |