Individual
NOGOL PEDRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
860 HAMPSHIRE RD STE P, WESTLAKE VILLAGE, CA 91361-6020
(805) 852-5055
Mailing address
506 S SPRING ST #13308, SMB 7649, LOS ANGELES, CA 90013
(559) 326-8395
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
CA
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2018
Last updated
04/10/2020
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