Individual
PAYAM ABRISHAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29525 CANWOOD ST STE 109, AGOURA HILLS, CA 91301-4230
(818) 338-7097
(818) 338-7099
Mailing address
1010 MONTEGO DR, LOS ANGELES, CA 90049-1617
(818) 338-7097
(818) 338-7099
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A86627
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A86627
CA
207ZD0900X
Dermatopathology (Pathology) Physician
A86627
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A866270
MEDI CAL
CA
01
—
P00729841
RAILROAD MEDICARE
CA
Enumeration date
06/29/2006
Last updated
10/06/2020
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