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Organization
M GANJIANPOUR, M.D. A PROFESSIONAL CORPORATION
Active
Organization
M GANJIANPOUR, M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GANJIANPOUR (MEDICAL DOCTOR)
(310) 855-0751
Entity
Organization
Contact information
Practice address
6330 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90048-5425
(310) 855-0751
Mailing address
6330 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90048-5425
(310) 855-0751
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A71028
CA
Other
Enumeration date
03/12/2010
Last updated
01/31/2014
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