Organization
ADVANCED LUNG CENTER MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMSHID NIKNAM M.D. (PRESIDENT)
(310) 275-7575
Entity
Organization
Contact information
Practice address
401 S LA BREA AVE STE 205, INGLEWOOD, CA 90301-2321
(310) 275-7575
Mailing address
401 S LA BREA AVE STE 205, INGLEWOOD, CA 90301-2321
(310) 275-7575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A52081
CA
207RP1001X
Pulmonary Disease Physician
Primary
A52081
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A520810
—
CA
Enumeration date
11/10/2006
Last updated
04/22/2014
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