Organization
CALIFORNIA INSTITUTE FOR CV&LVS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM EBRAHIMI M.D. (PRESIDENT)
(818) 422-5322
Entity
Organization
Contact information
Practice address
16030 VENTURA BLVD, 150, ENCINO, CA 91436-2731
(818) 900-2700
Mailing address
18375 VENTURA BLVD # 404, TARZANA, CA 91356-4218
(818) 422-5322
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A060777
CA
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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