Organization
DAN DARDASHTI, MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN ELIA DARDASHTI MD (PRESIDENT)
(818) 508-9190
Entity
Organization
Contact information
Practice address
12626 RIVERSIDE DR, SUITE #506, VALLEY VILLAGE, CA 91607-3420
(818) 508-9190
(818) 508-1648
Mailing address
12626 RIVERSIDE DR, SUITE #506, VALLEY VILLAGE, CA 91607-3420
(818) 508-9190
(818) 508-1648
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A61457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A614570
BLUESHIELD
CA
05
—
00A614570
—
CA
Enumeration date
06/25/2006
Last updated
07/02/2010
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