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Organization

CARDIOLOGY VASCULAR & ENDOCRINOLOGY CENTER PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KHAZAI BAHRAM M.D. (OWNER/PRESIDENT)
(615) 557-6692
Entity
Organization

Contact information

Practice address
2220 LYNN RD, THOUSAND OAKS, CA 91360-1904
(661) 395-3055
Mailing address
2220 LYNN RD, THOUSAND OAKS, CA 91360-1904
(661) 395-3055

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RE0101X
Endocrinology, Diabetes & Metabolism Physician

Other

Enumeration date
05/09/2024
Last updated
05/09/2024
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