Individual
DR. AHMADREZA MIRMIRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5123 GARDEN GROVE AVE, TARZANA, CA 91356-4340
(818) 983-3131
Mailing address
5123 GARDEN GROVE AVE, TARZANA, CA 91356-4340
(818) 983-3131
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
0439448
KS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
30995
OK
Other
Enumeration date
06/04/2013
Last updated
02/02/2017
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