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Individual

AMIR HOMAYON RAEESY-NEZHAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16311 VENTURA BLVD STE 955, ENCINO, CA 91436-4339
(818) 701-0017
(818) 817-5541
Mailing address
16311 VENTURA BLVD STE 955, ENCINO, CA 91436-4339
(818) 701-0017
(818) 817-5541

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36003
AZ
207R00000X
Internal Medicine Physician
Primary
A97308
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A97308
MEDICAL LICENSE
CA
Enumeration date
10/06/2006
Last updated
11/15/2022
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