Individual
MRS. BEHNOUSH MORTAZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C, MSN
Contact information
Practice address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
(213) 284-3352
Mailing address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
(213) 284-3352
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202470
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
20470
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
001263
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20470
NP LICENSE
CA
Enumeration date
03/23/2011
Last updated
10/22/2014
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