# GHOLAM R MOHAMMADZADEH MD INC A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1811320724
- **Authorized official:** GHOLAM R MOHAMMADZADEH M.D. (OWNER)
- **Authorized official phone:** (805) 379-6717

## Contact information

- **Practice address:** 77 ROLLING OAKS DR STE 202, THOUSAND OAKS, CA 91361-1018
- **Practice address phone:** (805) 379-6717
- **Practice address fax:** (805) 379-6719
- **Mailing address:** 77 ROLLING OAKS DR STE 202, THOUSAND OAKS, CA 91361-1018
- **Mailing address phone:** (805) 379-6717
- **Mailing address fax:** (805) 379-6719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2013
- **Last updated:** 06/25/2024