Organization
SHAHAB MEHDIZADEH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHAB MEHDIZADEH MD (PRESIDENT)
(310) 246-4100
Entity
Organization
Contact information
Practice address
240 S LA CIENEGA BLVD, 102, BEVERLY HILLS, CA 90211-3324
(310) 246-4100
(310) 285-2029
Mailing address
240 S LA CIENEGA BLVD, 102, BEVERLY HILLS, CA 90211-3324
(310) 246-4100
(310) 285-2029
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A76490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A76490
LICENSE
CA
Enumeration date
07/02/2007
Last updated
07/07/2011
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