Individual
GHOLAMREZA NAGADEH BONABI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
17075 DEVONSHIRE ST, SUITE 300, NORTHRIDGE, CA 91325-1600
(818) 368-4212
(818) 366-9351
Mailing address
17075 DEVONSHIRE ST, SUITE 300, NORTHRIDGE, CA 91325-1600
(818) 368-4212
(818) 366-9351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A46355
CA
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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