# M NOUSHKAM MD INC

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

## Provider details

- **NPI number:** 1770786022
- **Authorized official:** DR. NOHAMMAD B NOUSHKAM MD (OWNER CEO)
- **Authorized official phone:** (213) 389-5570

## Contact information

- **Practice address:** 274 ONE AND HALF S RAMPART BLVD, LOS ANGELES, CA 90057-1404
- **Practice address phone:** (213) 389-5570
- **Practice address fax:** (213) 389-5578
- **Mailing address:** 274 ONE AND HALF S RAMPART BLVD, LOS ANGELES, CA 90057-1404
- **Mailing address phone:** (213) 389-5570
- **Mailing address fax:** (213) 389-5578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A45935 | CA | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | A45935 | MEDICAL CERTIFICATE | CA |