Individual
ATA MAZAHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1560 E CHEVY CHASE DR, SUITE 450, GLENDALE, CA 91206-4197
(818) 246-3300
(818) 247-7600
Mailing address
20911 EARL ST, STE 245, TORRANCE, CA 90503-4355
(818) 247-7600
(818) 247-7126
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A79930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A799300
—
CA
Enumeration date
06/20/2006
Last updated
05/13/2016
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