Organization
MAZIAR GHODSIAN DO PC
Active
Other names
Proctology Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAZIAR GHODSIAN D.O. (PRESIDENT)
(800) 280-6384
Entity
Organization
Contact information
Practice address
300 S BEVERLY DR, SUITE 105, BEVERLY HILLS, CA 90212-4808
(800) 280-6384
Mailing address
300 S BEVERLY DR, SUITE 105, BEVERLY HILLS, CA 90212-4808
(800) 280-6384
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
20A9722
CA
Other
Enumeration date
11/01/2010
Last updated
09/15/2015
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