Individual
EMANOUEL KHODADADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN-FNP-BC
Contact information
Practice address
1818 VERDUGO BLVD STE 401, GLENDALE, CA 91208-1421
(818) 790-1145
(818) 790-6387
Mailing address
1818 VERDUGO BLVD STE 401, GLENDALE, CA 91208-1421
(818) 790-1145
(818) 790-6387
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP95032782
CA
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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