Organization
GHIASSI, MD INCORPORATED
Active
Other names
Ghiassi MD Incorporated
Organization subpart
No
Provider details
NPI number
Authorized official
JULEE MEDINA (CLINICAL COORDINATOR)
(310) 824-1262
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD STE 702, LOS ANGELES, CA 90025-6807
(310) 824-1262
(310) 824-5190
Mailing address
11645 WILSHIRE BLVD STE 702, LOS ANGELES, CA 90025-6807
(310) 824-1262
(310) 824-5190
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/27/2020
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