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Individual

BAKHTIAR MOUSSAZADEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5620 WILBUR AVE STE 305, TARZANA, CA 91356-1311
(818) 578-5326
(951) 272-9924
Mailing address
PO BOX 77790, CORONA, CA 92877-0126
(800) 626-2468
(951) 272-9924

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A108651
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A108651
MEDICAL LICENSE
CA
Enumeration date
06/04/2010
Last updated
02/16/2018
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