Individual
JAVID GHANDEHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 WILSHIRE BLVD STE 201, SANTA MONICA, CA 90403-5742
(310) 576-7267
Mailing address
150 W CIVIC CENTER DR STE 200, SANDY, UT 84070-4284
(888) 854-3822
(770) 701-6673
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A127144
CA
208600000X
Surgery Physician
125054209
IL
208VP0000X
Pain Medicine Physician
Primary
A127144
CA
Other
Enumeration date
08/05/2008
Last updated
10/01/2018
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