Organization
AZITA FAKHERI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZITA FAKHERI M.D. (OWNER)
(818) 343-0101
Entity
Organization
Contact information
Practice address
19100 VENTURA BLVD STE A, TARZANA, CA 91356-3238
(818) 343-0101
(818) 343-0269
Mailing address
18060 LAKE ENCINO DR, ENCINO, CA 91316-4432
(818) 343-0101
(818) 343-0269
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A69052
CA
Other
Enumeration date
09/12/2007
Last updated
01/02/2020
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