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Individual

SIAVASH BOLOURANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 315-6125
(310) 582-7185
Mailing address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 315-6125
(310) 582-7185

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A193634
CA
390200000X
Student in an Organized Health Care Education/Training Program
000000000000
NJ

Other

Enumeration date
04/11/2016
Last updated
05/27/2025
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