# POUYA LAVIAN MD INC A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1922429406
- **Authorized official:** DR. POUYA LAVIAN MD (PRESIDENT)
- **Authorized official phone:** (818) 394-0884

## Contact information

- **Practice address:** 16661 VENTURA BLVD STE 820, ENCINO, CA 91436-4801
- **Practice address phone:** (818) 394-0884
- **Practice address fax:** (818) 217-8318
- **Mailing address:** 16661 VENTURA BLVD STE 820, ENCINO, CA 91436-4801
- **Mailing address phone:** (818) 394-0884
- **Mailing address fax:** (818) 217-8318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | A109429 | CA | Yes |

## Other

- **Enumeration date:** 12/30/2013
- **Last updated:** 02/18/2014