Individual
AMIR SHAHRAM MAKOUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 WEST AVE Q SUITE D, PALMDALE, CA 93551
(661) 266-4500
(661) 266-4502
Mailing address
PO BOX 4008, LANCASTER, CA 93539-4008
(661) 266-4500
(661) 266-4502
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A75531
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOA755310
BLUESHIELD
CA
Enumeration date
08/21/2006
Last updated
07/21/2022
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