Organization
SHAHRIAR GHODSIAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRIAR GHODSIAN MD (PRESIDENT)
(310) 854-0606
Entity
Organization
Contact information
Practice address
2100 LYNN RD, SUITE 115, THOUSAND OAKS, CA 91360-1935
(310) 854-0606
(310) 914-9705
Mailing address
PO BOX 5265, BEVERLY HILLS, CA 90209-5265
(310) 854-0606
(310) 914-9705
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A72696
CA
207RP1001X
Pulmonary Disease Physician
Primary
A72696
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A726960
—
CA
Enumeration date
06/15/2011
Last updated
06/12/2014
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