Organization
B MOUSSAZADEH A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHEYENNE KAIPAT (OFFICE MANAGER)
(818) 588-4741
Entity
Organization
Contact information
Practice address
5620 WILBUR AVE STE 305, TARZANA, CA 91356-1311
(818) 588-4741
(818) 588-4748
Mailing address
5620 WILBUR AVE STE 305, TARZANA, CA 91356-1311
(818) 588-4741
(818) 588-4748
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A108651
CA
Other
Enumeration date
02/14/2018
Last updated
03/03/2020
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