Organization
ALEX A. KHADAVI MD INC
Active
Organization
ALEX A. KHADAVI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHIE L BYERS (MEDICAL BILLING MANAGER)
(661) 974-7954
Entity
Organization
Contact information
Practice address
16260 VENTURA BLVD, SUITE 140, ENCINO, CA 91436-5103
(818) 528-2500
(818) 528-2505
Mailing address
8539 W SUNSET BLVD, SUITE 4 BOX 132, WEST HOLLYWOOD, CA 90069-2334
(661) 974-7954
(661) 974-8365
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
Primary
—
—
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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