Individual
WESLEY GHASEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14860 ROSCOE BLVD STE 200, PANORAMA CITY, CA 91402-4683
(310) 553-5203
(310) 652-0933
Mailing address
1200 N STATE ST, CT-A7D, LOS ANGELES, CA 90033
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A153555
CA
207RI0011X
Interventional Cardiology Physician
A153555
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/18/2016
Last updated
07/06/2022
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