Organization
GERIATRIC PHYSICIAN ASSISTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMMAD REZA IRAVANI PA (OWNER/PHYSICIAN ASSISTANT)
(440) 506-3058
Entity
Organization
Contact information
Practice address
842 CORPORATE WAY, SUITE 850, WESTLAKE, OH 44145-1537
(440) 871-4700
(440) 871-4702
Mailing address
3843 SAVOY DR, FAIRVIEW PARK, OH 44126-1719
(440) 506-3058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001923
OH
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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