Individual
MARYAM TAVANAEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12660 RIVERSIDE DR STE 215, NORTH HOLLYWOOD, CA 91607-3430
(424) 314-7660
Mailing address
400 W PUEBLO ST OFC, SANTA BARBARA, CA 93105-4353
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A173242
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2018
Last updated
10/10/2023
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