Organization
COPA DE ORO MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAHMAN CHAVOSHAN MD (OWNER)
(562) 261-9330
Entity
Organization
Contact information
Practice address
12052 IMPERIAL HWY STE 102, NORWALK, CA 90650-3091
(310) 404-7171
Mailing address
12052 IMPERIAL HWY STE 102, NORWALK, CA 90650-3091
(562) 261-9330
(562) 543-3134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/23/2023
Last updated
08/06/2026
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