Individual
BEHROUZ ELIA DARDASHTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5363 BALBOA BLVD, #546, ENCINO, CA 91316
(818) 995-6003
(818) 995-3862
Mailing address
5363 BALBOA BLVD, #546, ENCINO, CA 91316
(818) 995-6003
(818) 995-3862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A38320
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A38370
—
CA
Enumeration date
12/11/2006
Last updated
07/08/2007
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