Organization
ALI R NAMAZIE MD A MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI R NAMAZIE MD (PRACTICE PRESIDENT)
(818) 986-5500
Entity
Organization
Contact information
Practice address
16661 VENTURA BLVD STE 226, ENCINO, CA 91436-1947
(818) 986-5500
(818) 986-5503
Mailing address
4955 VAN NUYS BLVD, SUITE 505, SHERMAN OAKS, CA 91403-1801
(818) 986-5500
(818) 986-5503
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A602910
BLUE SHIELD
CA
05
—
00A602910
—
CA
Enumeration date
04/26/2007
Last updated
02/20/2020
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